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Atlantoaxial Rotatory Subluxation [Fixation]

September 26, 2011 by Leave a Comment

Atlantoaxial rotatory subluxation is a condition where there is a fixed rotation of C1 over C2. This condition occurs when normal motion between the atlas and axis becomes limited or fixed either  spontaneously or following minor trauma [which usually is the case]. It can also  or follow an upper respiratory tract infection.

The cause of this subluxation is not completely understood. It is related to increased laxity of ligaments and capsular structures caused by inflammation or trauma.

Atlantoaxial rotatory subluxation is a common cause of childhood torticollis. Both the subluxation and torticollis usually are temporary. but rarely they persist and become  atlantoaxial rotatory fixation. [Read more...]

Filed Under: Cervical Spine Tagged With: , , ,

Familial Cervical Dysplasia

September 17, 2011 by Leave a Comment

In 1991 Saltzman et al. described a familial cervical dysplasia that affects the first cervical vertebra. It is an inherited form of cervical vertebral dysplasia which is transmitted as is autosomal dominant.

Presentation

Most of the patients with this condition are aymptomatic. The symptoms may vary from  an incidental finding on radiographic examination to a passively correctable head tilt.

There may be suboccipital headaches or limitation of cervical motion may occur. [Read more...]

Filed Under: Cervical Spine, Pediatric Disorders, Spine Tagged With: , ,

Xray Of Kyphosis At C3-C4 Cervical Vertebrae Due To Cervical Spine Instabilty

December 30, 2010 by Leave a Comment

The woman was 40 years old and had been admitted for hypertension and neckpain. She was apparently well about 3 days back when she started feeling pain in neck.

There were occasional episodes of vertigo.

Examination revealed tenderness at c4 level and there was mild loss of strength in her right hand grip.

The xray revealed reversal of lordosis and exaggereted kyphus at C3 C4 level.

The xray as shown above is an indicator of  severe cervical spine instability.

The patient was given a collar and sounded for need for operative intervention in form of fixation and fusion of C3-C4 vertebrae.

The patient does not want to undergo surgery and is satisfied with the collar for time being.

Filed Under: Cervical Spine, Spine Tagged With: , , , ,

What Is Basilar Impression?

June 4, 2010 by Leave a Comment

Basilar impression is an abnormality where the skull floor is indented by the upper cervical spine. The tip of the dens is more cephalad [towards head] and sometimes protrudes into the opening of the foramen magnum. This may cause brainstem encroachment and then risk neurologic damage from direct injury, vascular compromise, or cerebrospinal fluid flow alteration.

There are two types of basilar impression

  • Primary
  • Secondary

Primary basilar impression is a congenital abnormality often associated with other vertebral defects  like Klippel-Feil syndrome, odontoid abnormalities, atlanto-occipital fusion, and atlas hypoplasia. Primary basilar impression is found in 1% of the general population. [Read more...]

Filed Under: Cervical Spine Tagged With: , , ,

Approach To Patient With Neck Pain

April 3, 2008 by 1 Comment

Neck pain is almost as common a compliant as low back pain. The neck contains many pain-sensitive tissues, which are vulnerable to a variety of painful conditions. The cervical spine is quite mobile; situated between an immobile thorax and relatively weighty head, and thus it is subject varying degrees of trauma.

A patient with minor, self-limited neck pain may never consult a physician. Most of the patients who present with neck pain to a physician can be helped by conservative management. Patients with severe and chronic neck pain usually can be helped by the other therapeutic modalities. [Read more...]

Filed Under: Cervical Spine, Pain Management Tagged With: , , , , , , ,

Approach To The Patient With Shoulder Pain

February 18, 2008 by Leave a Comment

Shoulder pain can originate from many causes. Therefore, during the evaluation of shoulder pain, one should carefully note any history of trauma, infection, iniflammatory disease, occupational hazards, or previous cervical disease. It is important to know whether shoulder pain is continuous or is on specific movements only.

Apart from originating from shoulder itself, shoulder pain frequently is referred from the cervical spine and intrathoracic lesions i.e. Pancoast tumor, gallbladder, hepatic, or diaphragmatic disease. [Read more...]

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