Fusions (midterm) Flashcards
What are the 3 types of fusions?
1) congenital
2) acquired
3) surgical block vertebrae
Which type of fusion is this?
-concavity to the anterior
-rudimentary disc space
-decreased A->P diameter
-posterior motor unit fusion
congenital fusion
Which type of fusion is this?
-due to some pathology, DDD is most common
-osteophytes present
-LEO is present
acquired fusions
What is the other name for occipitalization of C1?
AO fusion
Congenital fusion of C1 to the base of the occiput and is a deformity of the AO junction
occipitalization of C1
When does occipitalization of C1 occur?
first few weeks of fetal life
What represents the most cephalic “blocked vertebra” encountered in the spine?
occipitalization of C1
If a patient with occipitalization of C1 has symptoms, what are they similar to? What are the symptoms?
similar symptoms to basilar impression
-headache
-diminished ROM
-visual and auditory abnormalities
-neural manifestations in the upper extremities
Which fusion would show this radiographic sign?
-lateral film shows a decreased or non-existent space between the posterior arch of C1 and the base of the occiput
-flexion/extension** films should be obtained to rule out motion between the posterior arch of C1 and the inferior border of the occiput
occipitalization of C1
In basilar impression, there is a decreased space between the occiput and the posterior arch of C1. What happens to the dens?
dens typically migrates superiorly
What is basilar impression associated with?
-occipitalization of C1
-spina bifida of C1
-odontoid abnormalities
-agenesis of C1
-Klippel-Feil syndrome
-Arnold-Chiari syndrome
What is Arnold-Chiari syndrome?
inferior portion of the cerebellar hemispheres and medulla protrude through the foramen magnum into the spinal canal, usually accompanied by spina bifida or meningomyelocele
What has these radiographic features?
-positive Chamberlain’s
-positive McGregor’s
-positive MacRae’s
-postive basilar angle
test q
basilar impression
In basilar impression, there is a lack of interosseous spacing between the occiput and the posterior arch of atlas. Where else are there congenital malformations?
C2-C5 vertebral bodies and neural arches
What is congenital block vertebra?
-2 adjacent vertebrae osseously fused together from birth
-failure of normal segmentation
-causes stress above or below the block vertebrae and results in premature degeneration
What is the most common segment for block vertebra?
C5/C6
What is the 2nd most common segment for block vertebra?
C2/C3
What fusion would have these radiographic features?
-decreased A->P diameter
-rudimentary disc space may show faint calcification
-possible fusion of apophyseal joints 50% of time (posterior motor unit)
-possible malformtion or fusion of SPs
-anterior concavity forming C shape
-wasp waist vertebra** with concavity to the anterior
-IVF present but smaller than normal
congenital block vertebra
What fusion is known to have “wasp waist” vertebra as its radiographic sign?
congenital block vertebra
What is this?
congenital block vertebra
What is this?
congenital block vertebra C2/C3 with rudimentary disc
What is this?
C2/C3 congenital block vertebra
What fusion has these classic signs?
-wasp waist vertebra
-c shaped anterior margin
-rudimentary disc
-fusion of posterior elements
congenital block vertebra
What syndrome has this classic triad?
-short webbed neck (pterygium colli)
-low hair line
-decreased cervical ROM
Klippel-Feil syndrome
