![]() AOSpine-Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles. Occipitocervical Dissociation-Incidence, Evaluation, and Treatment. Atlanto-Occipital Dislocation-Part 2: The Clinical Use of (Occipital) Condyle-C1 Interval, Comparison with Other Diagnostic Methods, and the Manifestation, Management, and Outcome of Atlanto-Occipital Dislocation in Children. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Reassessment of the Craniocervical Junction: Normal Values on CT. Rojas C, Bertozzi J, Martinez C, Whitlow J. Rheumatoid arthritis: CT/MRI will show atlantooccipital instability due to pannus destabilisation of joints and ligaments, and x-ray will show erosions Odontoid fracture: type 2 will cause posterior dens displacement and will disrupt Powers ratioĪtlanto-axial subluxation: atlantoaxial rotatory fixation will cause C1 lateral mass asymmetry relative to the densĭown syndrome: atlanto-occipital instability due to laxity of the alar ligament Jefferson fracture: anterior and posterior C1 ring fracture, possible lateral masses displacement Powers ratio >1 (insensitive to a vertical distraction injury or posterior dissociation)įor pediatric patients, the condyle-C1 interval (CCI) has been shown to provide the highest diagnostic accuracy 4.Ĭondyle-C1 interval (CCI) >4 mm in children The key to the diagnosis, in addition to identifying gross disruption of the normal alignment of the atlanto-occipital joint, hinges on using a number of lines on the lateral horizontal shoot-through cervical spine film 1:īasion-dens interval (BDI) >10 mm in adults 3īasion-axial interval (BAI) >12 mm in adults The AO Spine classification of upper cervical injuries is another classification system split into location-specific patterns and then further subdivided according to injury type and presence of neurological signs and/or modifying factors. The Traynelis classification describes injuries according to the displacement of the occipital condyles relative to the atlas. >2.5-3.The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3.part of a secondary survey or under the guidance of an authorized physician ensure this radiographic series is safe to perform, i.e.patients who feel unstable on their feet can sit in a chair for this examination.ensure the patient is aware when the examination is over as to avoid extended periods of time in that position.demonstrate to the patient what flexion and extension is before performing.extension images should demonstrate crowding of the spinous process. ![]()
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