C-T Junction John Heller What happens if you stay in the same place - - PowerPoint PPT Presentation
C-T Junction John Heller What happens if you stay in the same place too long My initial ACCF (C4-7) was in 2000 for CSM: Excellent clinical result. Re-op for C2-3 & 3-4 facet arthropathy & foraminal stenosis in 2010 with very good
John Heller
My initial ACCF (C4-7) was in 2000 for CSM: Excellent clinical result. Re-op for C2-3 & 3-4 facet arthropathy & foraminal stenosis in 2010 with very good relief.
2010 2011 2017
C7-T1 Deg. slip and synovial cyst evolved over 7 years. Severe C8 radicular pain.
2011 2017
C7-T1 Deg. slip (red arrow) and synovial cyst (blue arrow). Severe C8 radicular pain.
How to predict, let alone manage the fate of the cervico-thoracic junction remains a point of study.
Mark F. Kurd, MD Associate Professor, Department of Orthopaedics Thomas Jefferson University The Rothman Institute
C3-4 C4-5 C5-6 C6-7
C3-4 C4-5 C5-6 C6-7
Gregory D. Schroeder, MD Assistant Professor, Orthopaedic Surgery The Rothman Institute at Thomas Jefferson University
C3/4 C4/5
C5/6 C4/5 C6/7
C3-C7
Decompression
Thank You
Colin B. Harris, MD Assistant Professor Department of Orthopaedics Rutgers – New Jersey Medical School Newark, NJ
community hospital with progressive neck and upper back pain 4 months after a fall at home. Complains of both dull and sharp intermittent non-radiating pain 8/10 intensity, inability to hold head up.
no history of malignancy
no focal sensory deficit, +Hoffman’s, 3 beats clonus B/L
cervical tong traction for gradual kyphosis correction for 72 hours
in 5lb increments
– C3-C7 ACCF – C3-T3 posterior fusion with inst.
– Primary breast CA – ER/PR+ – HER2+
weeks postop
preserved motor/sensory function
Andrew K. Simpson, MD
– 6 months progressive myelopathy – Predominance of upper extremity manifestations – Diffuse UE paresthesias – Motor weakness C6-T1 distributions 3/5 - 4/5 – Superimposed C6 radiculopathy – Moderate axial neck pain, secondary complaint