Atlantoaxial Instability in Individuals with Down’s Syndrome

1984 ◽  
Vol 1 (3) ◽  
pp. 194-196 ◽  
Author(s):  
Robert E. Cooke
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Atlantoaxial Instability ◽  
X Rays ◽  
Neurological Damage ◽  
Cord Injury

Atlantoaxial Instability occurs in approximately 17% of all persons with Down’s syndrome. Such persons are susceptible to serious spinal cord injury if marked flexion of the neck occurs. Every person with Down’s syndrome should have cervical spine x-rays before performing in certain sports even though the frequency of sports-induced neurological damage is low.

Intracranial Hemorrhage and Spinal Cord Injury From a Fractured C1–C2 Sublaminar Cable

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. E1203-E1204 ◽  
Author(s):  
Udaya K. Kakarla ◽  
Juan Valdivia Valdivia ◽  
Volker K.H. Sonntag ◽  
Nicholas C. Bambakidis
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Mental Status ◽  
Intracranial Hemorrhage ◽  
Subdural Hematoma ◽  
Atlantoaxial Instability ◽  
Cord Injury ◽  
Spine Pathology

Abstract OBJECTIVE This is a unique case report of a fractured atlantoaxial interspinous multistranded cable leading to intracranial hemorrhage and spinal cord injury. CLINICAL PRESENTATION A 61-year-old woman, with a history of rheumatoid arthritis and C1-C2 interspinous wiring with allograft for atlantoaxial instability, presented with neck pain and progressive decline in mental status. Prior to transfer to our institution from a referral hospital, imaging studies revealed progressive hydrocephalus with interval development of subarachnoid and fourth ventricular hemorrhage. Initial and repeat angiographic work-up was negative for vascular lesions. Magnetic resonance imaging revealed a subdural hematoma and signal changes at the cervicomedullary junction. Computed tomography of the cervical spine revealed a fractured interspinous cable, intradural penetration, and atlantoaxial instability. INTERVENTION After ventriculostomy, both the patient's mental status and quadriparesis improved to a C on the American Spinal Injury Association (ASIA) scale. During surgery, the fractured cable and subdural hematoma were removed revealing an area of spinal cord impalement. She underwent C1-C3 lateral mass fixation with iliac crest autograft for fusion and was discharged to rehabilitation after a ventriculoperitoneal shunt was placed. At her 6-month follow-up, she was independent and had improved to ASIA E. Computed tomography confirmed fusion. CONCLUSION Spinal instrumentation eventually fails from pseudarthrosis and can cause neurological injury. In patients with atlantoaxial instability, direct C1-C2 screw fixation with posterior interspinous wiring using autograft offers the best chance for fusion. Cervical spine pathology can cause intracranial hemorrhage, and unconventional causes of injury must be considered when routine workup is negative.

The Torg-Pavlov ratio for the prediction of acute spinal cord injury after a minor trauma to the cervical spine

2013 ◽  
Vol 13 (6) ◽  
pp. 605-612 ◽  
Author(s):  
Nikolaus Aebli ◽  
Anina G. Wicki ◽  
Tabea B. Rüegg ◽  
Nassos Petrou ◽  
Heidrun Eisenlohr ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Acute Spinal Cord Injury ◽  
Minor Trauma ◽  
Cord Injury ◽  
A Minor

Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries At the Cervical Spine

2021 ◽  
Author(s):  
Marie-Helene Beausejour ◽  
Eric Wagnac ◽  
Pierre-Jean Arnoux ◽  
Jean-Marc Mac-Thiong ◽  
Yvan Petit
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
White Matter ◽  
Cervical Spinal Cord ◽  
Element Model ◽  
Von Mises Stress ◽  
Study Objective ◽  
Cord Injury ◽  
Post Traumatic

Abstract Flexion-distraction injuries frequently cause traumatic cervical spinal cord injury (SCI). Post-traumatic instability can cause aggravation of the secondary SCI during patient's care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how different flexion-distraction disco-ligamentous injuries affect the SCI mechanisms during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4-C5, C5-C6 or C6-C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the most extreme von Mises stress (47 to 66 kPa), principal strains p1 (0.32 to 0.41 in white matter) and p3 (-0.78 to -0.96 in white matter) in the spinal cord and to the most important spinal cord compression (35 to 48 %). The main post-trauma SCI mechanism was identified as compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter after injury. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure in protecting the spinal cord. Its status should be carefully examined during patient's management.

Interactivating Rehabilitation through Active Multimodal Feedback and Guidance

2013 ◽  
pp. 1650-1674
Author(s):  
Bert Bongers ◽  
Stuart Smith
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Initial Phase ◽  
Training Methods ◽  
Neurological Damage ◽  
Multimodal Feedback ◽  
Novel Technologies ◽  
Patient Interactions ◽  
Cord Injury ◽  
Insight Into

This chapter outlines a Human-Computer Interaction inspired approach to rehabilitation of neurological damage (e.g. spinal cord injury) that employs novel, computer guided multimodal feedback in the form of video games or generation of musical content. The authors report an initial exploratory phase of a project aimed at gaining insight into the development of spinal cord injury (SCI) rehabilitation tools. This exploration included observation of a number of patient interactions in their current rehabilitation routines; the development of initial prototype proposals; and finally through to the development of rapid prototypes which can be used in rehabilitation settings. This initial phase has yielded an understanding of the issues surrounding the development of novel technologies for rehabilitation that will direct further research in the area of rehabilitation engineering. Through the integration of novel methods, in particular the use of interactive physical devices, to the rehabilitation of SCI patients, larger scale research into efficacy of the devices we are developing can be undertaken. These developments may eventually beneficially impact upon the instruments used, the training methods applied and the rehabilitation routines undertaken for individuals living with neurological damage.

Fractures of the spine in children

2011 ◽  
Author(s):  
James Wilson-MacDonald ◽  
Colin Nnadi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injuries ◽  
Healthy Children ◽  
X Rays ◽  
Radiographic Abnormality ◽  
Cord Injury ◽  
High Incidence ◽  
Fractures Of The Spine ◽  
Epiphyseal Plates

♦ Spinal injuries in children are rare♦ Pseudosubluxation above C4 is common in healthy children so the sign needs careful interpretation♦ Epiphyseal plates and a high incidence of skeletal variability make the interpretation of spinal x-rays in children difficult. Anterior wedging is also normal as is interpedicular widening♦ Spinal cord injury without radiographic abnormality (SCIWORA) may occur for up to one-third of spinal injuries in children♦ Deformity secondary to trauma tends to deteriorate with growth.

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