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Up to 10% of patients with rheumatoid arthritis are at risk of sudden death due to unrecognized cord compression. [2] Thus surgical intervention is a reasonable choice in the presence of a neurologic deficit as a result of instability. In fact, early surgery for atlantoaxial subluxation may actually delay the debilitating progress of myelopathy ...
Craniocervical instability is more common in people with a connective tissue disease, including Ehlers-Danlos syndromes, [1] osteogenesis imperfecta, and rheumatoid arthritis. [2] It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation , [ 3 ] or tethered spinal cord syndrome .
The distances between the dens and surrounding structures are also key features that can suggest the diagnosis, with the normal distance between the dens and basion (i.e., dens–basion interval; BDI) measuring less than 9 mm on CT, and the distance between the atlas and dens (i.e., atlas–dens interval; ADI) measuring less than 3 mm on CT, although this can be increased in cases of ...
Surgery may be used to fix the joint and any associated bone fractures. [1] Neck movement may be reduced long after this injury. [1] Such injuries may also lead to hypermobility, which may be diagnosed with radiographs. [2] This is especially true if traction is used during treatment. [2]
A widening of the atlanto-axial joint, as measured between the posterior surface of the anterior arch of atlas and the front of the odontoid process, indicates an injury to the transverse atlantal ligament. [6] Normally, this atlanto-dental distance is less than 2 mm, sometimes a maximum of 3 mm is accepted in men and 2.5 mm in women. [6]
The treatment of choice for transverse ligament cysts with progressive neurological decline is surgical resection and cervical fusion. [4] Conservative treatment with external neck immobilization is less commonly reported , but may be very useful in select cases where immediate surgical intervention is not indicated.
[3]: 426 Laterally, the membrane blends with the articular capsules. [1] It is superficial/anterior to the dura mater of the spinal canal (onto which it attaches). [4] [1] The membrane overlies the grooves for vertebral arteries, vertebral venous plexuses, and cervical spinal nerves C1. [1] The membrane forms the floor of the suboccipital triangle.
Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement. [citation needed] This sense of the term "reduction" does not imply any sort of removal or quantitative decrease but rather implies a restoration: re ("back [to initial position]") + ducere ("lead"/"bring"), i.e., "bringing back to ...