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11 Cards in this Set
- Front
- Back
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What are the criteria for atlantoaxial instability in the adult and in the child?
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Adult: >3 mm motion
Child: >4 mm motion |
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What is the significance if >7 mm motion is seen at C1-2?
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Alar ligaments also disrupted
Contraindication to elective orthopaedic surgery |
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A posterior atlanto-dens interval (PADI) smaller than ____ is an indication for surgery.
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14 mm
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What are the expected surgical outcomes if PADI is 10 to 14 mm or <10 mm?
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10 to 14 mm: can expect neurologic improvement postoperatively
<10 mm: stabilize; improvement unlikely |
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What is the critical PADI value in flexed position?
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Surgery indicated if <6 mm in flexion
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What are the two additional operative indications at C1-2?
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>10mm motion
Myelopathy |
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What four surgical options are appropriate if subluxation is reducible?
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Gallie technique
Brooks technique Transarticular screws |
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What three surgical options are appropriate if subluxation is irreducible? What is the key step to all three?
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Posterior decompression with occiput-C2 fusion
Posterior decompression with C1-2 transarticular screws |
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What is the expected long term consequence without surgery for instability?
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On average, patients die within 8 years
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What are the three criteria that indicate that surgery is less likely to be successful? What is the Ranawat category?
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Objective weakness
Upper motor neuron (UMN) signs Nonambulatory Ranawat IIIB |
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Upon which two factors is the Nurick classification of myelopathy based?
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Gait
Ambulatory function |
