Cervical Spine Instability
Determining cervical spine instability is difficult due to the fact that it can contribute to many clinical presentations of several conditions including: cervicogenic headaches, chronic whiplash dysfunction, rheumatoid and osteoarthritis, and disc degeneration. It is therefore imperative that a thorough evaluation be completed. Upper cervical stability testing should be completed if the patient reports having a headache, nausea, dizziness, occipital numbness or tinnitus.
Cervical instability can be caused by a traumatic event, but it is most often due to a disease process including:
Cardinal Symptoms
Examination Tests
Neurological examination of cranial nerves, upper motor neuron, and cerebellar function should be performed if cervical instability is suspected.
Cervical instability can be caused by a traumatic event, but it is most often due to a disease process including:
- Down Syndrome and atlantoaxial instability
- Rheumatoid Arthritis
- Klippel-Feil Syndrome
- Ehlers-Danlos Syndrome or Marfan’s Syndrome
Cardinal Symptoms
- Drop attacks
- Nystagmus that is produced by active/passive movements of the head/neck
- Bilateral, quadrilateral, or hemilateral paresthesia/anesthesia
- Facial and perioral paresthesia /anesthesia
- Other Signs: Dysarthria, dysphagia, numbness of the tongue, metallic taste in the mouth (CN VII)
Examination Tests
- Transverse Ligament Stress Test
- Anterior Shear Test
- Distraction Test
- Alar Ligament Stress Test
- Transverse Shear Test for Integrity of the Dens
Neurological examination of cranial nerves, upper motor neuron, and cerebellar function should be performed if cervical instability is suspected.
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