Spine Injuries

deformity", consists of tilting to one side but rotation towards the other. In this condition, the muscular spasm is on the side to which the chin points. Spasmodic muscular torticollis is the primary differential consideration. In atlantoaxial rotatory fixation, the muscles are attempting to correct the deformity, whereas in torticollis the muscles are causing the deformity.

Although the pathophysiology of this condition is not completely understood, the inflammatory response which occurs as a result of an infection or an effusion from trauma has been theorized to cause an infolding and even a disruption of the synovial folds in the atlantoaxial joints.

Plain radiographs and CT scanning constitute the imaging modalities of choice. AP views show deviation of the spinous process of the axis towards the side of the chin tilt, accompanied by counter-rotation of the subaxial spine. This radiologic finding is known as the "Sudeck's sign". This occurs as the patient makes a conscious effort to realign the deformity. Fine-cut CT scanning from the occiput through C3 help clarify the plain film findings.

Halter traction with incremental weights until the head resumes a midline position constitutes the initial treatment; a post-reduction CT scan is done before the patient is placed in a Guilford brace for 3 months. Recurrence, although unusual, is usually treated with another trial of traction and halo immobilization. Failure of reduction or a second recurrence mandates treatment with a C1-C2 fusion.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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