Download Disorders of the Cervical Spine by Eurig Jeffreys (Eds.) PDF

By Eurig Jeffreys (Eds.)

This name may still entice the orthopaedic health care professional, the neurologist, the neurosurgeon and the rheumatologist who all percentage universal floor with admire to the cervical backbone

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Example text

Still's disease affecting young children may, however, prove an exception. Fusion itself does not cause any specific problems but may lead to abnormal stress and early degen­ eration above and below the lesion and, in the case of ankylosing spondylitis, increases the risk of fracture from minor injury. Rheumatoid destruction of the discs and posterior joints are well demonstrated by plain radiographs and these changes may result in segmental instability and the forward subluxation of one vertebra on another.

Cruciate ligament intact. active, never passive, movement should be part of the routine screening of these children as soon as they can cooperate (Wynne-Davies et aL, 1989). The soft tissues are also faulty in Morquio's disease and atlanto-axial displacement is inevitable. The onset of symptoms and signs is insidious and present as fatigue, or complaints of tingling in the extremities. Assessment is difficult because of the joint laxity characteris­ tic of the condition. The head and neck may be held extended because 'it feels safe'.

Six secondary centres appear at puberty. These are two annular circumferential epiphyseal discs above and below the body, two secondary centres at the tip of the spinous process and two more at the tips of the trans­ verse processes. Occasionally these secondary centres do not fuse with the primary centres at the end of skeletal growth. The atlas and axis ossify differently. The atlas ossifies from three centres. Those of the two lateral masses appear in the seventh intrauterine week and extend backwards into the posterior arch to unite in the fourth year.

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