Post on 04-Jan-2016
Lines of Mensuration Continued
• Cervical Spine Lordosis– Depth Measurement (range of 7=17)– Method of Jochuvisen (range 1-9)
• anterior body of atlas
• anterior/superior C7
• measure C5 to line
– Angle of curve - each disc space– C1-C7 lordosis
Lines of Mensuration Continued
• Prevertebral space maximum– C1 - C5 - 7mm– C5 - C7 - 20mm
• Penning Analysis
COMMON CONDITIONS
• Postural
• AP Curves– Normal - lordosis with dens over
anterior/superior corner of C7– Abnormal - hy[erlordosis, hypolordosis,
reversal
Common Conditions Continued
– Hypolordosis/Reversal due to:• trauma
• muscle spasm
• degenerative joint disease
• posterior laminectomy (with decreased or reusal of the sagittal curve there is a decreased response to corrective decompression
Common Conditions Continued
– Sagittal - curves, scoliosis, tower– Dr. Wittmer study– Pre and post cervical spine molding
• no clear evidence of benefit
Common Conditions Continued
• Degenerative Joint Disease– Spondylosis– Uncovertebral arthrosis– Facet arthrosis– Motion alteration– Compression effects– X-ray often NOT predictive
Common Conditions Continued
• ADI– Child up to 5.0mm– Adult up to 3.0mm– Stress view in flexion/extension– Decreased ADI - arthritis– Increased ADI
TRAUMA with the rupture of the transverse ligament
• Much less common than Den’s fracture
• Transverse ligament rupture much greater threat to life
• Guillotime effect - Guillotine
• Most common type is Type II Den’s fracture, its unstable
• Type I and Type III is stable
• Type I israre, Type III is a close second
INFECTION: INFLAMMATORY
ARTHRITIDE
• Rheumatoid arthritis
• Psoriasis
• Ankylosing spondylitis
• Reiter’s
Trauma
• Jefferson’s Fracture– C1 ring fracture (significant neurological deficit or
death, which is uncommon– Decompression– Greater or equal to two fracture locations– Axial load
• Posterior Arch Fracture– most common– 80% will have other cervical spine fracture