Upper Cervical Spine
A 35-year-old woman with long-standing rheumatoid arthritis presents with neck pain, occipital headaches, and recent onset of hand clumsiness. Flexion-extension lateral cervical radiographs show an atlanto-dental interval (ADI) of 9mm that increases to 12mm with flexion. MRI shows pannus formation around the odontoid with cord signal change. Regarding atlanto-axial instability:
Mark each as TRUE or FALSE
The atlanto-axial joint (C1-C2) allows 50% of cervical rotation; stability depends primarily on the ...
Causes of atlanto-axial instability include rheumatoid arthritis (pannus erodes transverse ligament)...
The atlanto-axial joint contributes minimal cervical rotation; stability depends primarily on the al...
Clinical features include neck pain, occipital headaches (C2 nerve irritation), myelopathic symptoms...
Treatment of symptomatic atlanto-axial instability is posterior C1-C2 fusion; techniques include Gal...
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Click T (True) or F (False) for each option