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Lines of Mensuration Continued

Lines of Mensuration Continued. Cervical Spine Lordosis Depth Measurement (range of 7=17) Method of Jochuvisen (range 1-9) anterior body of atlas anterior/superior C7 measure C5 to line Angle of curve - each disc space C1-C7 lordosis. Lines of Mensuration Continued.

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Lines of Mensuration Continued

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  1. Lines of Mensuration Continued • Cervical Spine Lordosis • Depth Measurement (range of 7=17) • Method of Jochuvisen (range 1-9) • anterior body of atlas • anterior/superior C7 • measure C5 to line • Angle of curve - each disc space • C1-C7 lordosis

  2. Lines of Mensuration Continued • Prevertebral space maximum • C1 - C5 - 7mm • C5 - C7 - 20mm • Penning Analysis

  3. COMMON CONDITIONS • Postural • AP Curves • Normal - lordosis with dens over anterior/superior corner of C7 • Abnormal - hy[erlordosis, hypolordosis, reversal

  4. Common Conditions Continued • Hypolordosis/Reversal due to: • trauma • muscle spasm • degenerative joint disease • posterior laminectomy (with decreased or reusal of the sagittal curve there is a decreased response to corrective decompression

  5. Common Conditions Continued • Sagittal - curves, scoliosis, tower • Dr. Wittmer study • Pre and post cervical spine molding • no clear evidence of benefit

  6. Common Conditions Continued • Degenerative Joint Disease • Spondylosis • Uncovertebral arthrosis • Facet arthrosis • Motion alteration • Compression effects • X-ray often NOTpredictive

  7. Common Conditions Continued • ADI • Child up to 5.0mm • Adult up to 3.0mm • Stress view in flexion/extension • Decreased ADI - arthritis • Increased ADI

  8. TRAUMA with the rupture of the transverse ligament • Much less common than Den’s fracture • Transverse ligament rupture much greater threat to life • Guillotime effect - Guillotine • Most common type is Type II Den’s fracture, its unstable • Type I and Type III is stable • Type I israre, Type III is a close second

  9. INFECTION: INFLAMMATORY ARTHRITIDE • Rheumatoid arthritis • Psoriasis • Ankylosing spondylitis • Reiter’s

  10. Trauma • Jefferson’s Fracture • C1 ring fracture (significant neurological deficit or death, which is uncommon • Decompression • Greater or equal to two fracture locations • Axial load • Posterior Arch Fracture • most common • 80% will have other cervical spine fracture

  11. Hangman’s Fracture (traumatic spondylolisthesis) • C2 fracture among most common cervical spine fractures • 40% of axis fractures are hangman • result from MVA with abrupt deceleration and/or compression and hyperextension • bilateral pedicle fracture • 25%

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