PPT-Management of Cervical Spine Disease in Down's Syndrome: 

A Neurosurgical perspective   Dominic Thompson Department of Paediatric Neurosurgery Great Ormond Street London Flemish 1515 Anon Am J Med Genetics Cervical spinal pathology in Downs syndrome. Chapter 11 . Anatomy. Spinal column. Vertebrae. Cervical (7). convex anteriorly. Thoracic (12). concave anteriorly. Lumbar (5). convex anteriorly. Sacral (5 fused). concave anteriorly. Coccyx (4 fused). SPINE TRAUMA . CERVICAL SPINE INJURY. THORACO-LUMBAR SPINE INJURY. CERVICAL SPINE INJURY. COMMON MECHANISMS OF INJURY. . HYPERFLEXION- . MVA, CAR COMES TO SUDDEN STOP. HYPEREXTENSION- MVA, CAR STRUCK FROM BEHIND. Normal Anatomy. Normal stability of any joint is made of 2 aspects. Static Stabilisers – osseous configuration, capsules and ligaments. Dynamic Stabilisers- muscle function through dynamic ligament tension, force couples, joint compression and/or neuromuscular control . Shari Cui MD & John France MD. February 2016. Original: . . Steven . Frick, MD; March 2004. . Past Revised. : . Steven Frick, MD; August 2006. . Timothy . Moore, MD; November . 2011. Important Pediatric Differences. Shari Cui MD & John France MD. February 2016. Original: . . Steven . Frick, MD; March 2004. . Past Revised. : . Steven Frick, MD; August 2006. . Timothy . Moore, MD; November . 2011. Important Pediatric Differences. Jim . Messerly. D.O.. Nothing to Disclose. Low Back Pain- Where’s the Pain Coming From???. Possible Low Back Pain Generators. Discogenic. Pain- With or Without Radicular Pain. Facet Joint Pain- Usually Axial Low Back Pain. neuro. deficits, and a . negative CT. High clinical suspicion and severe . c. ervical . s. pondylosis. -> . MRI. Otherwise . use clinical judgment, but likely no benefit from MRI and increased risk of . Dr . La li Sekho n MD , PhD , FRACS , FACS , FAAN S Curr i cu l u m V it a e CONTACT DETA I L S ls e khon @ sierr an e u r o s u r g er y .c o m T el : 775 - 323 - 2080 F a x : 775 - 657 - 9881 S ierr Typical Cervical Vertebra C3-6. Small, relatively broad body. Bifid . Spinous. Process. Long and narrow . laminae. Spinal Canal:. large, triangular; remarkably consistent dimensions. Transverse Foramen:. Fractures. Ruling out fractures in direct access environment. Negative X rays does not guarantee there is not fracture. Clinical recognition of fracture is difficult . Clinical Indicators. Trauma. Immediate posttraumatic onset of severe pain. Content. : Ryan Martin, MD; Sarah Peacock, DNP, APRN. ACNP-BC; . Megan Corry, EdD, EMTP; Kerri L. LaRovere, MD; Safdar A. Ansari, MD . Slides. : Ryan Martin, MD.  .  .  .  . Presenter:. Your name. Stanford Hospital and Clinics. April 26, 2010. Motion segment. VERTEBRAE. Carry 70-90% of static axial load. Vary in cervical, thoracic, lumbar, sacral and . coccygeal. FACET JOINT. Carry 10-20% of static axial load. Dr. Hani Al Sheikh Radhi. Triage. is the process of determining the priority of patients' treatments based on the severity of their condition.. Trauma Severity Score. Injury Severity Score. Glasgow Coma Scale. PATHOPHYSIOLOGY. 25% cervical trauma occurs in the upper cervical spine.. Most commonly involving the axis, comprising up to 20% of cervical spine injuries.. Atlas fractures occur in 3 – 13% of patients..