Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 738.4 Acquired spondylolisthesis756.12 Spondylolisthesis congenital805.01 Closed fracture of first cervical vertebra ++ M43.10 Spondylolisthesis, site unspecifiedQ76.2 Congenital spondylolisthesisS12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation1 +++ Description ++ Anterior (forward) translation of a vertebraFracture of the anterior and posterior arches of C1 vertebraSlipping of the vertebra in relationship to the vertebra belowAtaxiaFracture widens at the pars +++ Essentials of Diagnosis ++ Diagnosis made by x-rayClinical examination may find step deformityAxial load on top of the headReports diving into a shallow pool +++ General Considerations ++ InstabilityAvoid extension positions that increase symptoms +++ Demographics ++ Usually from landing on head, as with diving into a shallow pool +++ Signs and Symptoms ++ AtaxiaInjury to vertebral arteryCervical, shoulder, arm, upper-extremity pain; often radiating into lower extremities if central cord involvedConstricted pupil (Horner’s sign)Stiffness along spineHeadachesPain in cervical spine worsens with extension +++ Functional Implications ++ Difficulty maintaining standing postures secondary to neck painDifficulty with movements (reaching overhead) secondary to painLimited sports participationCan cause quadriplegia or death +++ Possible Contributing Causes ++ Forceful extension from hit under the chin (as in sports)Car accident, hit from rearHyperextension of the cervical spineDiving into a shallow pool +++ Differential Diagnosis ++ Peripheral nerve impairmentSpinal tumorPeripheral neuropathyParaspinal spasmsDegenerative disk diseaseHangman’s fractureC2 vertebra anterior translated on C3 with fracture of C2 pedicles +++ Imaging ++ MRI helps to visualize compressed or inflamed nerve root in diagnosisX-ray/plain-film radiograph to see vertebra positionCT to show herniation compressing the spinal canal/nervesElectrodiagnostic/nerve conduction testing can help to determine a specific impaired nerve function ++ Fracture of the anterior and posterior arches of C1 vertebra ++ To hospital for imagingTo surgeon for surgical consult if myelopathy suspectedFusionTo physician for anti-inflammatory medicationTo orthopedist for halo vest traction device, cervical bracing ++ Restricted mobility of the upper cervical spineHypermobilityNoted weakness of neck musculature ++ RestBracingAddress painElectrical stimulationHeat/iceAddress hypertonicitySoft tissue massageHeatAddress muscle weaknessStability exercises ++ Patient will be able to Sit with neutral cervical-spine posture for greater than 30 minutes with 0 out of 10 pain ratingStand at work station and perform computer work for 45 minutes with 0 out ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth