Download - Lines of Mensuration Continued
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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
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Lines of Mensuration Continued
• Prevertebral space maximum– C1 - C5 - 7mm– C5 - C7 - 20mm
• Penning Analysis
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COMMON CONDITIONS
• Postural • AP Curves
– Normal - lordosis with dens over anterior/superior corner of C7
– Abnormal - hy[erlordosis, hypolordosis, reversal
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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
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Common Conditions Continued
– Sagittal - curves, scoliosis, tower– Dr. Wittmer study– Pre and post cervical spine molding
• no clear evidence of benefit
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Common Conditions Continued
• Degenerative Joint Disease– Spondylosis– Uncovertebral arthrosis– Facet arthrosis– Motion alteration– Compression effects– X-ray often NOT predictive
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Common Conditions Continued
• ADI– Child up to 5.0mm– Adult up to 3.0mm– Stress view in flexion/extension– Decreased ADI - arthritis– Increased ADI
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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
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INFECTION: INFLAMMATORY
ARTHRITIDE• Rheumatoid arthritis• Psoriasis• Ankylosing spondylitis• Reiter’s
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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
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Hangman’s Fracture (traumatic spondylolisthesis)
• C2 fracture among most common cervical spine fractures
• 40% of axis fractures are hangman• result from MVA with abrupt deceleration
and/or compression and hyperextension• bilateral pedicle fracture
– 25%