Presentation on theme: "Cervical Instability in the EDS Population"— Presentation transcript:
1Cervical Instability in the EDS Population EDNF 2012 ConferenceAugust 2012Cervical Instability in the EDS PopulationA. Atiq Durrani, MDCenter For Advanced Spine TechnologiesCincinnati, OHAll rights reserved.
2Cervical Spine Issues in EDS C1-C2 instabilityCranio-cervical Instability.Lower Cervical kyphosis.Cervical disc degeneration ( Most common at C4-5, C5-6).Chiari Malformation
22% uncovering of facets Blue line measures the C2 facet. EDNF 2012 ConferenceAugust 2012% uncovering of facetsBlue line measures the C2 facet.Green line measures the amount of C1 facet that covers C2.With these numbers, % uncovered can be calculated.All rights reserved.
43Outcomes Between 1/2009 and 8/2011, N= 25. 1 year follow up. All patients underwent stabilization for C1-C2.
44Outcomes. Mean Pre-op Pain – 8 Mean post op pain at one year- 2 One patient still had residual pain.Screw fracture in one patient.Headaches resolved in 92% of patients.Will you do this procedure again – 95%.
45ConclusionCervical Spinal Instability is a common reason for EDS patients suffering from headaches and Cranio-Cervical pain.It is under- appreciated by the spine community and not very well understood.In many circumstances, patients complaining of such complaints go through extensive work up with no treatment offered in the end.Stabilization of O-C1-C2, complex resolves cranio-cervical symptoms in EDS patients.
53Classical type (formerly Types I and II) EDS Signs and symptoms include:Loose jointsHighly elastic, velvety skinFragile skin that bruises or tears easilyRedundant skin folds, such as on the eyelidsSlow and poor wound healing leading to wide scarringNoncancerous fibrous growths on pressure areas, such as elbows and knees; fatty growths on the shins and forearmsMuscle fatigue and painHeart valve problems (mitral valve prolapse and aortic root dilation)
54Hypermobility type (formerly type III) EDS Signs and symptoms include:Loose, unstable joints with many dislocationsEasy bruisingMuscle fatigue and painChronic degenerative joint diseaseAdvanced premature osteoarthritis with chronic painHeart valve problems (mitral valve prolapse and aortic root dilation)
55Vascular type (formerly type IV) EDS This type of EDS is rare, but it's one of the most serious. It affects an estimated 1 in 100,000 to 200,000 people. Signs and symptoms include:Fragile blood vessels and organs that are prone to tearing (rupture)Thin, translucent skin that bruises easilyCharacteristic facial appearance, including protruding eyes, thin nose and lips, sunken cheeks and small chinCollapsed lung (pneumothorax)Heart valve problems (mitral valve prolapse and others)
56ComplicationsDepend on your symptoms and type of EDS, but some common ones include:Prominent scarringDifficulty with surgical wounds — stitches may tear out, or healing may be incompleteChronic joint painJoint dislocationEarly onset arthritisPremature aging with sun exposure
57Complications with Vascular EDS Serious complications can arise with vascular EDS such asTearing (rupture) of major blood vessels,i.e., ruptured or dissected artery or an aneurysm,rupture of organs, such as the intestines or uterus.These complications can be fatal. About 1 in 4 people with vascular type EDS develop a significant health problem by age 20, and more than 80 percent develop complications by age 40. The median age of death is 48 years.