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Stability of the upper cervical spine is highly dependent on ligaments and membranes. These are best appreciated on magnetic resonance imaging (MRI), which can reveal damage to these structures in traumatic, congenital, infectious, and inflammatory conditions. It can also be used to evaluate the spinal cord and spinal canal to assess neurologic compression and cord pathology. Given the potential for devastating neurologic consequences in the setting of upper cervical instability and neural structure compression or injury, MRI is an invaluable tool for evaluation of the craniocervical junction.

Objective: Cervical pedicle screw (CPS) fixation is widely used for the treatment of cervical spinal instability from various causes; however, there are few reports on the long-term outcomes of this procedure. The present study evaluated the 10-year results of CPS fixation for cervical instability. Methods: The medical records of 13 consecutive patients who underwent computer-guided CPS fixation for cervical instability were reviewed. The mean observation period was 153 months. Evaluated items included Japanese Orthopaedic Association (JOA) score and C2-7 lordotic angle before surgery and at 5 and 10 years afterwards. Visual analog scale (VAS) scores for neck pain and radiological evidence of adjacent segment degeneration (ASD) at 10 years of follow-up were also assessed. Results: Mean JOA score significantly improved from 9.4 points before surgery to 13.2 points at 5 years after surgery (p

Cervical spine stabilization is a procedure frequently performed by neurosurgeons and orthopedic surgeons to treat spinal instability, which is the loss of the spine's ability to tolerate pain, structural deformity, or neurological damage under normal conditions. Cervical instability can be caused by traumatic injury, infection, cancer, and degenerative processes. Surgical treatment of any of these conditions requires removing bone, which can increase spinal instability. Stabilization procedures typically use instrumentation and bone grafts to restore the spine to its normal condition. The surgical goal is to provide the best environment for the formation of bone fusion.

Cervical spine stabilization is a procedure frequently performed by neurosurgeons and orthopedic surgeons to treat spinal instability, which is the loss of the spine's ability to tolerate pain, structural deformity, or neurological damage under normal conditions. Cervical instability can be caused by traumatic injury, infection, cancer, and degenerative processes. Surgical treatment of any of these conditions requires removing bone, which can increase spinal instability. Stabilization procedures typically use instrumentation and bone grafts to restore the spine to its normal condition. The surgical goal is to provide the best environment for the formation of bone fusion.

SUMMARY. The aim of this preliminary study was to investigate the reliability of a selection of manual tests used for the examination of instability of the upper cervical region. Eleven children with Down's syndrome were examined by four independent examiners with different levels of experience in manual therapy. Three tests as described by Van der El (1992) were used: the lateral displacement test, the Sharp-Purser test, and the upper cervical flexion test. Scores of tests and retests were statistically analysed by calculating the percentage of agreement, and Brennan and Prediger's modified kappa, and with the binomial test. The results showed a significant agreement between test and retest for the upper cervical flexion test in three out of four investigators. Agreement between investigators was significant in four out of six combinations between two investigators, and near to significant for this test (P(bin) =.07) in the two remaining combinations. The other two investigated tests and the total score showed no tendancy towards a consistent level of significant intra- or interobserver reliability. Copyright 1997 Harcourt Publishers Ltd.