Stabilization Of The Atlantoaxial Complex

Pain is rated at 3-4/10. The patient saw Dr. Abbassi on 05/07/15 who recommended diagnostic medial branch blocks around L4-L5 and L5-S1 on the right side, 2 levels. The patient would like the medial branch blocks to be done. Dr. Abbassi further writes, “I believe he is a candidate for diagnostic medial branch blocks, 2 levels, at the time starting from L4-L5 and L5-S1 on the right, later L2- L3 and L3-L4 if he still has pain, and if these injections help him for a short while but significantly and then the pain returns then radiofrequency ablation is an option.” Diagnoses are chronic fracture of T8, upper thoracic pain, lumbar pain with radiation to left L5 region with left L5 radicular pain with moderate listhesis at L4-5 and mild to moderate bilateral L5-S1 denervation. Treatment plan includes diagnostic medial branch blocks, 2 levels, right sided, at L4-L5 and L5-S1, to await approval for physical therapy, modified duty, and follow-up in 4 weeks.

In fact, the postoperative group experienced a successful result. The comparison of patients who had surgery prove that gains in health and physical ability persevere for several years. For example, postoperative patients’ improvements in hearing, breathing, communicating, and mental functioning exceeded the results of others. Although the postoperative group had the worst scores for breathing due to the greater necessity placed on the cardiorespiratory system, this finding is interpreted as a sign of successful treatment. (Rissanen et al., 1995). Overall, physical ability was significantly improved in the postoperative groups. Major improvements were shown for pain, sleep, and mobility. Activities of daily living (ADL) were significantly enhanced after

Recommendation was made for anterior cervical discectomy with fusion C5-6, possible C4-5. He has agreed to proceed surgically.

cervical discectomy and fusion performed on 04/14/15. The latest progress report noted that the patient has neck pain, upper back pain, and shooting pain down the arms. The exam revealed that the DTRs were mildly diminished in the left upper extremity. The strength and sensation were mildly diminished in the left upper extremity as well. Spurling sign was also weakly positive on the left. It is noted that the patient has tried and failed conservative treatment, including medications and PT. However, review of the records revealed that the postop PT was put on hold due to his increased pain. In addition, the MRI Report showed that the disc space was normal and there was no significant disc herniation at the requested level i.e. C7-T1. The spinal canal and neural foramen are patent. In addition, EMG Report revealed that there was no evidence of peripheral nerve entrapment or underlying peripheral neuropathy on nerve conduction studies. Considering the minimal/mild physical examination findings and normal imaging and EDS testing; the medical necessity of C7-T1 cervical ESI has not been established. Recommend

DOI: 8/24/2008. Patient is a 55-year-old female manager who sustained injury to her neck and back when she slipped and fell while walking down a set of pull out stairs. Per OMNI, she is diagnosed with cervical strain with radiculopathy and lumbar radiculopathy. She underwent C5-6 partial corpectomy and fusion in 05/31/2011.

DOI: 9/26/2015. Patient is a 29-year-old male construction worker who sustained a work-related injury to his neck, back, left shoulder and right knee when he slipped and fell. He is status post left shoulder arthroscopy on 8/05/2016.

The resultant image demonstrated a possible atlanto-axial instability with anterior dislocation of C1 (fig. 1(a)). According to (Booth, 2012), the anterior and posterior cervical and spinolaminar lines should be assessed (fig. 1(c)) recognizing that

12/31/15 Progress Report described that the patient has cervical spine, right shoulder, and right wrist pain. She rates her cervical spine at 8/10-scale level and frequent; right shoulder pain at 8/10-scale level; and bilateral wrist pain at 6/10-scale level. The pain is frequent and improved since last visit. Rest and medications make the pain better. Weather

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

A few days later he was screened by a physician. The doctor located anterior pain on his anterior spine. Eventually he was given a CT and X-ray which both confirmed an avulsion of part of the iliac crest apophysis which is another word for an outgrowth or projection of a bone. The surgery team performed an open reduction and internal fixation with two titanium fixed screws. A CT scan was given and confirmed adequate screw placement following the procedure.

Pedicle screw fixation is the preferred technique for number of spinal disorders, there are a lot complications with this technique during surgery, like hardware failure, pseudarthrosis, screw misplacement [9,10]. Pedicle Screw failure occurs even after surgery from breakage, screw loosening, pullout [2,9,11-14]

The adductors as a group are really a powerhouse. They have a lot of combined muscle fibers and through their attachment sites on the pelvis and the femur, significantly influence the body’s alignment. Because they originate and have such a presence on the pelvis, shortened adductors will influence the tilt and transverse rotation of the pelvis. The thorax is intimately connected and sometimes anchored to the pelvis through muscles such as the Quadratus Lumborum, the Rectus Abdominis and the Transverse, Internal and External Obliques. Any shift in the pelvis toward neutrality as a result of bodywork on the adductors will directly affect the muscles that connect the pelvis and the thorax and thus will create space for the thorax to shift

After successful osseointegrated implant therapy, one of the most common complications has been the screw loosening. The importance of abutment screw tightening with proper preload continues to be emphasized. Not only is a minimum torque critical, but excessive torque may exceed the yield strength of the screw, resulting in permanent deformation, loss of mechanical, and screw fracture. Problems associated with abutment screw loosening and fracture may be due to inaccurate fit and improper tightening.

In cases of instability due to fractures, reduction needs to be addressed first to ensure integrity of the joint anatomy to allow soft tissue healing. In cases of distal radius fractures, reduction and restoration of radial alignment is necessary and long term results show no difference in outcomes of conservative or surgical approaches following adequate fixation (42). Ulnar head dislocations may require reduction and temporary fixation with K-wires. For fractures of the ulnar styloid, fixation of the radius alone may have the same results as ulnar styloid fixation

Differential Diagnosis: Could be an injury to the deltoid ligament, CF, or the ATF ligament.