The detection of cervical spine instability was found to significantly affect anaesthetic management, favouring techniques that avoided unprotected manipulations of the neck under anaesthesia. Anterior atlantoaxial subluxation was the most common subluxation encountered in our study population. We showed that a complete X-ray examination of the cervical spine should include flexion and extension stress views in addition to frontal views of the odontoid and entire cervical spine. Many anaesthetists did not repeat cervical spine X-rays if there were previously performed views available. We found that while the majority of patients had received preoperative X-ray screening for cervical spine instability, a third of the X-ray examinations done had been inadequate. type II: the atlas is rotated on one lateral articular process with 3 to 5 mm of anterior displacement. X-rays can be taken separately for the three areas of the spine: the cervical spine (neck), thoracic spine (middle back), and lumbar spine (lower back). We reviewed retrospectively 77 patients who underwent 132 operations under general or regional anaesthesia over a 44-month period. rotatory subluxation, known as atlantoaxial rotatory fixation (AARF) is characterized into four different types according to the Fielding and Hawkins classification 3 : type I: the atlas is rotated on the odontoid with no anterior displacement. Doctors use back x-rays to examine the vertebrae in the spine for fractures, arthritis, or spine deformities such as scoliosis, as well as for signs of infection or cancer. The cervical spine is frequently involved in rheumatoid arthritis and yet there exists no consensus on the need to screen for cervical spine subluxations preoperatively.
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