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Background: The variation of C1 spinolaminar line in normal population is not fully understood. The relative position of C1 lamina to C3-C2 spinolaminar line is reported as good screening tool for determination of C1 canal stenosis., Objective: To determine the variation of C1 spinolaminar line and find the prevalence of C1 canal stenosis in normal population using C3-C2 spinolaminar test., Materials and Methods: Three hundred and fifteen lateral cervical radiographs from 315 volunteers without neurological symptoms were analyzed. The relative position of C1 spinolaminar line was determined by C3-C2 spinolaminar and considered positive if C1 lamina lay ventral to C3-C2 line. C1 space available for cord (SAC) was measured from posterior border of dens to the C1 lamina to determine the sagittal diameter., Results: The mean sagittal spinal canal diameter of C1 was 22.2 mm (13-26 mm). Of 315, 14 (4.4%) had positive, 184 (58.4%) had neutral, and 117 (37.1%) had negative C1 spinolaminar line in relation to C3-C2 line. The mean SAC among positive group was 14.9 mm compared to neutral and negative groups which were 22.2 and 23.3 mm, respectively. 21.4% of positive group had SAC of less than 12 mm. The 92.8% of positive C1 spinolaminar line was found in age ≥ 60 years., Conclusion: In a normal population, 4.4% has positive C1 spinolaminar line. The C1 stenosis is more prevalent in positive C1 spinolaminar line group.

Background: The description of the measurement technique of the posterior occiput-third cervical spine (OC3) angle-before performing occipitocervical fusion is still controversial. Setting an appropriate alignment in occipitocervical instrumentation is important for successful fixation surgery. Several methods were used for quantifying occipitocervical alignment on the lateral radiograph. This study was performed to describe a measurement technique of OC3 angle and comparing reliability and reproducibility in the measurement of occipitocervical angle with previous method. The purpose of this study was to determine the best technique for assessing this angle., Materials and Methods: Three hundred and twenty-six lateral cervical spine radiographs from volunteers without spinal disorder were taken in neutral position and collected from June 2011 to December 2012. Analysis consisted of measurement of the OC3 angle and posterior occipitocervical angle. Inter- and intra-observer reliabilities were assessed using limit agreement test., Results: The mean OC3 angle measurements were approximately 107 (94-120) degrees. Intra- and inter-observer error assessed by 95% limit agreement was approximately ±5.5 and ±7.5, while the POCA measurements were approximately 108 (94-120) degrees. Intra- and inter-observer error assessed by 95% limit agreement was approximately ±13.3 and ±18.2., Conclusion: The OC3 angle measurement is a simple method, good inter- and intra-observer reliabilities to measure of the occipitocervical angle. That can be useful to setting the patient's position and facilitate confirmation of the occipitocervical neutral position during occipitocervical fusion.

Objective: A retrospective study was performed in case with three and four levels degenerative cervical spondylosis that underwent anterior cervical discectomy and fusion (ACDF) with polyetheretherketone (PEEK) cages and anterior cervical plate to evaluate the efficacy and outcome., Material and Method: Clinical and radiographic results of 16 patients (6 women and 10 men) between January 2006 and June 2009 with follow-up more than 24 months were evaluated Spinal curvature, segmental sagittal angulations, construct height and the radiographic fusion success rate were measured Odom's criteria, visual analog scale (VAS), Nurick and modified JOA (Japanese Orthopedic Association) score were used to assess the clinical results., Results: There was significant difference between pre- and post-operative in degree of lordosis, segmental Cobb angle and clinical outcomes (p < 0.01). Clinical outcomes were classified as 'excellent' or 'good' according to Odom's criteria in 14 patients (success rate: 87.5%). Mean follow-up period was 36 months. Flexion and extension lateral radiographs showed 100% fusion rate. The construct height and sagittal alignment were maintained on the final follow-up observations. No cage failure, subsiding or dislodgement was showed on follow-up radiographs., Conclusion: Interbody fusion with PEEK cages packed with bone substitute and aspirated bone marrow which additions of cervical plate eliminate the complications of graft harvest and is a good option for the treatment of patients with three and four levels degenerative cervical spondylosis.

Background Basal cell adenocarcinomas are rare malignant neoplasms of salivary glands, accounting for <1% of salivary gland tumors. Few cases of distant metastases have been reported. Case Description A 50-year-old Thai man was diagnosed with basal cell adenocarcinoma of the submandibular gland with pulmonary and cervical spine metastases with progressive myelopathy. He was treated with wide surgical resection of the soft tissue tumor and modified radical neck dissection, anterior cervical total corpectomy with fusion combined with posterior decompression and fusion of the cervical spine, and surgical wound coverage by anterolateral thigh free tissue transfer, followed by adjuvant radiotherapy. At 18-month follow-up, the patient remained in good condition, and no signs of local recurrence or contiguous spreading were detected. Postoperative radiographs showed solid osseous fusion without loss of correction or implant failure. Conclusions This case highlighted an extremely rare condition of metastatic basal cell adenocarcinoma of the submandibular gland to the lung and spine, which, to our knowledge, has not been previously reported in the literature. [ABSTRACT FROM AUTHOR]