cranio cervical junction -dr. k.shanmuganathan
TRANSCRIPT
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Imaging of the Cervical Spine: Cranio-cervical Junction
3rd National Conference SER 2016Bengaluru, India 23-25 September 2016
K.SHANMUGANATHAN. M.D.
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Imaging of the Cervical Spine: Craniocervical Junction
Objectives•Axis Fx’s -Dens fracture, Hangman’s fracture•Atlanto-occipital dissociation (AOD)•Normal anatomy
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DENS FRACTURE
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DENS FRACTURE
• Commonest Fx > 65 Yrs
• Mechanism – MVC & fall
• Three types
• Type II - nonunion
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DENS FRACTURE
• Subtle on lateral radiographs & axial CT
• Step off or disruption – cortex or C2 ring
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Anderso & D’Alonzo in: The Radiology of Acute Cervical Spine TraumaHarris JH , Mirvis SE
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Courtesy of Mann FA
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TRAUMATIC SPONDYLOLISTHESIS
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TRAUMATIC SPONDYLOLISTHESIS
• Hyperextension & axial loading
• Pars interarticularis
• MVC
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Effendi et al The Radiology of Acute Cervical Spine TraumaHarris JH , Mirvis SE
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C2-3 C2-3
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ATLANTO-OCCIPITAL DISSOCIATION
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ATLANTO-OCCIPITAL DISSOCIATION
• Uncommon injury
• Three types – direction the skull displaces
Anterior, Posterior, Vertical
• Subtle – radiographs, CT, MRI
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ATLANTO-OCCIPITAL DISSOCIATION
• X- line method
• Powers ratio
• Basion-dental interval (BDI)
Basion-axial interval (BAI)
> 12 mm
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ATLANTO-OCCIPITAL DISSOCIATION
Measurement Radiograph MDCTBDI 12 mm 9.5 mm
BAI/PAL 12 mm 5.4 mm
Condylar sum - 6.2 mm
R L
+
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>12mm
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BO
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7 mm
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ADC E1 E 2&E3
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