Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory:...
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Transcript of Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory:...
![Page 1: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/1.jpg)
Spectrum of pathology
• Prolapsed discs and osteophytic compression; ‘wear and repair’
• Inflammatory: rheumatoid, ankylosing spondylitis
• Trauma: odontoid, rotatory subluxation• Neoplastic: meningiomas, schwannomas,
metastatic cord compression• Congenital Klippel Feil, fused, Down’s,
enterogenous cysts
![Page 2: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/2.jpg)
43 yr male, brachalgia C5 right
![Page 3: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/3.jpg)
![Page 4: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/4.jpg)
![Page 5: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/5.jpg)
![Page 6: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/6.jpg)
Spectrum of pathology
• Prolapsed discs, osteophytic compression: ‘wear and repair’
• Inflammatory: rheumatoid, ankylosing spondylitis• Trauma: odontoid, rotatory subluxation• Neoplastic: meningiomas, schwannomas,
metastatic cord compression• Congenital Klippel Feil, fused, Down’s,
enterogenous cysts• Infection: discitis, osteomyelitis, epidural
abscess
![Page 7: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/7.jpg)
•S.R. - Male, Age 77•Severe Rheumatoid Arthritis•Past multiple joint replacements and episodes of steroid Px•Progressive upper and lower limb long tract symp/signs•Neck Pain and Stiffness
![Page 8: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/8.jpg)
![Page 9: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/9.jpg)
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Occipitocervical fixation
![Page 11: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/11.jpg)
Halo support post-op
![Page 12: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/12.jpg)
![Page 13: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/13.jpg)
Sub axial rheumatoid deformity
![Page 14: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/14.jpg)
Seronegative arthritis
![Page 15: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/15.jpg)
Ankylosing spondylitis
![Page 16: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/16.jpg)
Spectrum of pathology
• Prolapsed discs, osteophytic compression: ‘wear and repair’
• Inflammatory: rheumatoid, ankylosing spondylitis• Trauma: odontoid, rotatory subluxation• Neoplastic: meningiomas, schwannomas,
metastatic cord compression• Congenital Klippel Feil, fused, Down’s,
enterogenous cysts• Infection: discitis, osteomyelitis, epidural
abscess
![Page 17: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/17.jpg)
Odontoid fracture
![Page 18: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/18.jpg)
Odontoid screw fixation
![Page 19: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/19.jpg)
Hangman’s fracture
![Page 20: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/20.jpg)
C6 Crush fracture, posterior ligamentous injury
![Page 21: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/21.jpg)
Interspinous ligamentous disruption
![Page 22: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/22.jpg)
Hyperextension injury, ALL disrupted
![Page 23: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/23.jpg)
Rotatory subluxation
![Page 24: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/24.jpg)
![Page 25: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/25.jpg)
![Page 26: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/26.jpg)
Pre reduction MR
![Page 27: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/27.jpg)
![Page 28: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/28.jpg)
![Page 29: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/29.jpg)
![Page 30: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/30.jpg)
![Page 31: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/31.jpg)
![Page 32: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/32.jpg)
![Page 33: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/33.jpg)
![Page 34: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/34.jpg)
![Page 35: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/35.jpg)
![Page 36: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/36.jpg)
Interspinous ligamentous disruption
![Page 37: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/37.jpg)
Posterior reduction and fixation techniques
• Currette or hook• Drilling/ nibbling the superior aspect of the inferior facet• Wires • Hooks or clamps• Screws/ Plates• Screws/ Rod combinations
![Page 38: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/38.jpg)
![Page 39: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/39.jpg)
Spectrum of pathology
• Prolapsed discs, osteophytic compression: ‘wear and repair’
• Inflammatory: rheumatoid, ankylosing spondylitis• Trauma: odontoid, rotatory subluxation• Neoplastic: meningiomas, schwannomas,
metastatic cord compression• Congenital Klippel Feil, fused, Down’s,
enterogenous cysts• Infection: discitis, osteomyelitis, epidural
abscess
![Page 40: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/40.jpg)
![Page 41: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/41.jpg)
![Page 42: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/42.jpg)
![Page 43: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/43.jpg)
Ependymoma Gd 2
![Page 44: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/44.jpg)
51 years neck , arm pain
![Page 45: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/45.jpg)
NHL cervical cord compression
![Page 46: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/46.jpg)
CT pelvis: right inguinal lymphadenopathy
![Page 47: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/47.jpg)
2 years post op
![Page 48: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/48.jpg)
Patchell, Lancet 2005
![Page 49: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/49.jpg)
Complications
General (DVT, MI, Infection, haematoma)
Specific: Recurrent and sup laryngeal n
Dysphasia
Retropharyngeal haematoma
Nerve root injury
Spinal cord injury
Vertebral artery injury
![Page 50: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/50.jpg)
The future
• Better analysis of results
• Better constructs• Clearer indications• More work
• Ceramic vs plastics vs metal
• Interface with bone • Bone growth
stimulants• Genetically
engineered solutions
![Page 51: Spectrum of pathology Prolapsed discs and osteophytic compression; wear and repair Inflammatory: rheumatoid, ankylosing spondylitis Trauma: odontoid, rotatory.](https://reader034.fdocuments.us/reader034/viewer/2022051819/5513d4c355034674748b4e8e/html5/thumbnails/51.jpg)
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