dynamic instability

[onechance]

What do you guys do if some one has dynamic instability at C2-3, minimal 2mm, no symptoms, just neck pain.
Do you still refer to a surgeon?

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[bedrock]

What do you guys do if some one has dynamic instability at C2-3, minimal 2mm, no symptoms, just neck pain.
Do you still refer to a surgeon?

2mm doesn't qualify. Needs to be at least 4mm.

--RF C2-C3.

 

[SSdoc33]

2mm doesn't qualify. Needs to be at least 4mm.

--RF C2-C3.

Rf an unstable segment? Bogduk may not think the multifidi do anything, but u are not gonna ADD stability by denervating them

 

[101N]

What do you guys do if some one has dynamic instability at C2-3, minimal 2mm, no symptoms, just neck pain.
Do you still refer to a surgeon?

Are there cord signal changes on MRI?

 

[bedrock]

Rf an unstable segment? Bogduk may not think the multifidi do anything, but u are not gonna ADD stability by denervating them

2mm doesn't meet any published criteria of instability. If no stenosis, cord changes, radicular symptoms, or long tract signs, then you treat the axial neck pain.

If they fail basic meds-----RF.

 

[onechance]

She awaits MRI.

 

[101N]

She awaits MRI.

Then so does your answer.

 

[pmrmd]

Inject the C2-3 joint first. IA or capsular. You may not need to progress to RF. No way a surgeon is needed for this.

 

[PMR 4 MSK]

Get a consult from a non-knife happy spine surgeon to CYA and then treat as desired.

 

[onechance]

Thank you all.