Oxford Textbook Of Geriatric Medicine by J. Grimley Evans and T. Franklin Williams (Editors)

By J. Grimley Evans and T. Franklin Williams (Editors)

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MRI for neurologic symptoms and to assess soft tissue ligamentous injury. • Flexion/extension views may be used to assess for instability in the absence of bony trauma. • Vertebral body fracture. • Clay shoveler fracture due to sudden strong force applied to the ligamentum nuchae. • Congenital midline cleft abnormality. IMAGING FINDINGS • Hangman’s fracture of C2 (unstable): Traumatic listhesis of C2 on C3 with bilateral pars interarticularis fractures that may involve the vertebral body. OTHER RECOMMENDED TESTING TREATMENT • Immobilization of the cervical spine is the first line of treatment.

The anterior muscles flex the neck, resist neck hyperextension, and act independently to turn the head. 25 26 Part 2 • Spine Lateral Muscles. The lateral group consists of the anterior, middle, and posterior scalene muscles, and the sternocleidomastoid. The scalene muscles act to laterally flex the neck and assist inspiration by elevating the first and second ribs. NEURAL STRUCTURES The Spinal Nerves. These are made up of a confluence of dorsal and ventral roots, each root being composed of smaller rootlets.

There is also multilevel disc bulging, and several of the disc bulges lie in contact with the anterior aspect of the cervical cord. (B), However, on the axial T2W MR image, there is no significant central canal stenosis or cord compression. 2 Sagittal CT myelogram demonstrating disc bulging that is most marked at the C3-C4 level. CHAPTER 16 Intervertebral Disc Herniation of the Cervical Spine DEFINITION • Focal extension of the intervertebral disc of less than 50% of the disc circumference beyond the margins of the vertebra.

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