Cervical Spine Instability

Upper Cervical Instability

Usually this occurs between the atlas (C1) and axis (C2)

Problems may arise as a result of failure or rupture of various ligaments that contribute stability to the C1-2 complex. Other problems may arise from a neglected or missed fracture dens (known as os odontoideum)

 

Case Presentation

 

Male early twenties

Fall onto head, complaining of severe neck pain

Physical Examination findings

Severe upper cervical tenderness, pain radiating to occipital region

No neurological deficit

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EXTENSION

FLEXION

DIAGNOSIS

C1-2 Instability

AADI from 2mm in extension to 10mm in flexion

CT SCAN

MRI—Transverse Ligament Rupture / Avulsion on left side

TREATMENT

STABILISATION OF C1-C2

CHOICE OF METHOD

NO NEED FOR DECOMPRESSION

STABILISATION METHOD

 

C1-2 TRASARTICULAR (MAGERL) SCREWS with BONE GRAFTING and GALLIE WIRING

SPINE CARE HONG KONG

ACCURATE DIAGNOSIS, STRUCTURED TREATMENT