Spine Instability (cervical spine)

Question 1

what conditions can result in atraumatic cervical spine instability

Answer 1

down syndrome and rheumatoid arthritis

Question 2

what are children with down syndrome at risk of

Answer 2

atlanto-axial (C1/C2) instability with subluxation potentially causing spinal cord compression

Question 3

what screening can be used to demonstrate this subluxation

Answer 3

flexion-extension xrays (high atlanto-dens interval)

Question 4

what must children with minor degrees of instability be prevented form taking part in

Answer 4

high impact/contact sports

Question 5

what might severe instability or the presence of abnormal neurology require

Answer 5

surgical stabilisation

Question 6

what other condition can atlanto-axial subluxation occur with

Answer 6

rheumatoid arthritis

Question 7

why can atlanto-axial subluxation occur in rheumatoid arthritis

Answer 7

destruction of synovial joint between the atlas and the dens and rupture of the transverse ligament

Question 8

what is the treatment for less severe cases (seen on flexion-extension views)

Answer 8

a collar too prevent flexion

Question 9

what is the treatment for more severe cases

Answer 9

surgical fusion

Question 10

why do lower cervical subluxations occur

Answer 10

destruction of synovial facet joints and uncovertebral joints again with potential for cord compression with upper neurone signs

Question 11

what are some upper neurone signs

Answer 11

wide based gait, weakness, increased tone, upping plantar response