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Published byCaroline Mason Modified over 11 years ago
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Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory subluxation Neoplastic: meningiomas, schwannomas, metastatic cord compression Congenital Klippel Feil, fused, Downs, enterogenous cysts
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43 yr male, brachalgia C5 right
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Spectrum of pathology Prolapsed discs, osteophytic compression: wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory subluxation Neoplastic: meningiomas, schwannomas, metastatic cord compression Congenital Klippel Feil, fused, Downs, enterogenous cysts Infection: discitis, osteomyelitis, epidural abscess
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S.R. - Male, Age 77 Severe Rheumatoid Arthritis Past multiple joint replacements and episodes of steroid Px Progressive upper and lower limb long tract symp/signs Neck Pain and Stiffness
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Occipitocervical fixation
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Halo support post-op
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Sub axial rheumatoid deformity
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Seronegative arthritis
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Ankylosing spondylitis
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Spectrum of pathology Prolapsed discs, osteophytic compression: wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory subluxation Neoplastic: meningiomas, schwannomas, metastatic cord compression Congenital Klippel Feil, fused, Downs, enterogenous cysts Infection: discitis, osteomyelitis, epidural abscess
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Odontoid fracture
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Odontoid screw fixation
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Hangmans fracture
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C6 Crush fracture, posterior ligamentous injury
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Interspinous ligamentous disruption
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Hyperextension injury, ALL disrupted
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Rotatory subluxation
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Pre reduction MR
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Interspinous ligamentous disruption
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Posterior reduction and fixation techniques Currette or hook Drilling/ nibbling the superior aspect of the inferior facet Wires Hooks or clamps Screws/ Plates Screws/ Rod combinations
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Spectrum of pathology Prolapsed discs, osteophytic compression: wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory subluxation Neoplastic: meningiomas, schwannomas, metastatic cord compression Congenital Klippel Feil, fused, Downs, enterogenous cysts Infection: discitis, osteomyelitis, epidural abscess
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Ependymoma Gd 2
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51 years neck, arm pain
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NHL cervical cord compression
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CT pelvis: right inguinal lymphadenopathy
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2 years post op
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Patchell, Lancet 2005
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Complications General (DVT, MI, Infection, haematoma) Specific: Recurrent and sup laryngeal n Dysphasia Retropharyngeal haematoma Nerve root injury Spinal cord injury Vertebral artery injury
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The future Better analysis of results Better constructs Clearer indications More work Ceramic vs plastics vs metal Interface with bone Bone growth stimulants Genetically engineered solutions
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