Search Results

You are looking at 1 - 6 of 6 items for :

  • "subluxation" x
  • By Author: Casey, Adrian T. H. x
Clear All
Restricted access

Adrian T. H. Casey, H. Alan Crockard, J. Martin Bland, John Stevens, Ronald Moskovich and Andrew Ransford

I nvolvement of the atlantoaxial region by the rheumatoid process is a well-known clinical and radiological entity. Clinical or neurological disability is typically classified using the Ranawat system (Classes I–IIIb) and radiological findings of atlantoaxial disease, including those of horizontal, lateral, or rotary subluxation and vertical translocation. 33 However, because there is often no apparent relationship between the degree of subluxation measured radiologically using the atlantodens interval (ADI) and the clinical picture, 1, 7, 21, 28 there is a

Restricted access

Ali Abou Madawi, Adrian T. H. Casey, Guirish A. Solanki, Gerald Tuite, Robert Veres and H. Alan Crockard

the lateral mass or roof of the VA groove; and 3) depth of the VA groove, that is, the difference between the first two measurements ( Fig. 1B ). Surgical Technique The patients were anesthetized using fiberoptic nasotracheal intubation and placed prone on the operating table. Somatosensory evoked potentials were monitored throughout the procedure. 14 A Mayfield head fixation set was used to secure the head, and the atlantoaxial subluxation was reduced with the aid of control fluoroscopy. Surgery was performed with the lower cervical spine in extension and

Restricted access

Adrian T. H. Casey, H. Alan Crockard and John Stevens

incapacitated, largely or wholly bed-ridden or 48 40  confined to a wheelchair w/ little or no self-care * Perioperative deaths were categorized as Ranawat Class IIIB. Development of Surgical Management The type of surgery was influenced by the reducibility of the deformity (fixed or mobile), the associated cervical subluxations present (horizontal, lateral, or rotatory atlantoaxial subluxation), and the presence of subaxial disease. 12 The latter, in particular, dictated the extent of instrumentation required, with an attempt to

Restricted access

Adrian T. H. Casey, H. Alan Crockard, Jennian F. Geddes and John Stevens

provide some important insights into the pathomechanics of vertical translocation and its clinical sequelae. The main thrust of the analysis was a comparison between patients with atlantoaxial subluxation and those with vertical translocation based on their demonstrated clinical and radiological features. Clinical Material and Methods This was a prospective observational study, in the course of which 256 patients were recruited over a 10-year period (1983–1993). Of the total, 186 patients had myelopathy (Ranawat Classes II, IIIA, and IIIB) 35 and underwent spinal

Restricted access

Ali Nader-Sepahi, Adrian T. H. Casey, Richard Hayward, H. Alan Crockard and Dominic Thompson

A tlantoaxial subluxation associated with ligamentous laxity is a well-known entity in 15 to 20% of patients with Down syndrome, yet symptomatic atlantoaxial global subluxation is estimated to occur in only 1% of cases. Symptoms may include neck pain, cervical deformity, cervicomedullary compression leading to neurological deficit, and even sudden death. The indications for surgical intervention and the nature of the most appropriate surgical stabilization technique for these children remain controversial. Previous studies have highlighted significant

Restricted access

Robin Bhatia, Ruth M. Desouza, Jonathan Bull and Adrian T. H. Casey

insertion of C1–2 screws), and Klippel-Feil syndrome (14%); metabolic conditions, including osteogenesis imperfecta, Scheie syndrome, and Forestier disease (6%); other inflammatory conditions, including odontoid pseudotumor and myopathy resulting in chin-on-chest deformity (6%); and infection (C-1 staphylococcal infection and occipitocervical tuberculosis; 2%). The commonest clinical indications for OCF were progressive myelopathy, in large part due to vertical odontoid translocation (65%), atlantoaxial subluxation not amenable to posterior C1–2 fixation (30%, including