cervical spine instability

Question 1

atraumatic causes

Answer 1

occurs in people with downs syndrome and those with rheumatoid arthritis

Question 2

down syndrome

Answer 2

children with down syndrome are at risk of developing atlanto-axial instability which can result in spinal cord compression, quadriplegia and death

Question 3

screening for cervical spine instability

Answer 3

using flexion-extension x-rays, if there is atlanto-axial instability it will show a high atlanto-dens interval

Question 4

if downs syndrome children do have atlanto-axial instability

Answer 4

if mild they may only have to be prevented from high impact sport if more severe then surgical stabilisation

Question 5

rheumatoid arthritis

Answer 5

atlanto-axial subluxation is due to destruction of the synovial joint between the dens and atlas and because of rupture of the transverse ligament

Question 6

management of atlanto-axial instability

Answer 6

less severe cases can be treated with a collar while more severe cases require surgical fusion