C3-C7 Fractures Flashcards
What is the diagnosis?
Compression Fx
What is the mechanism of a cervical compression fracture?
Compressive (axial load) hyperflexion
What is the stability of a cervical compression fracture?
Stable
(No neuro deficit, uncomplicated healing)
What are the radiographic findings of a cervical compression fracture?
Anterior wedging on lateral view (post. column intact)
If you have a patient with a history of acute trauma, and a wedged vertebra on radiographs, how would you determine a new injury from an old one?
(Dx: compressio Fx)
- Compare with old imaging
- if none, MRI for bone marrow edema
What structures are injured in a cervical burst fracture?
Fx of anterior and posterior parts of body, possibly post. elements
What is the mechanism of a cervical burst fracture?
Axial compression (^^force) w/ or w/o flexion
What is the stability of a cervical burst fracture?
Unstable
(85% have neuro deficit d/t cord damage)
What are the radiographic findings of a burst fracture?
- Loss of anterior & posterior body height
- retropulsion of fragments
- angular kyphosis, spinous fanning, facet dislocation
What are the most common levels of an articular pillar fracture?
C4-C7, usually unilateral
What is the mechanism of an articular pillar fracture?
Hyperextension w/ or w/o lateral flexion
What is the stability of an articular pillar fracture?
Stable
What is the clinical presentation of an articular pillar fracture?
Focal pinpoint tenderness of posterior elements
What are the radiographic findings of an articular pillar fracture?
- loss of pillar height
- frequent associated Fx (pedicle, lamina)
What imaging modality is best to visualize an articular pillar fracture?
CT
What is the differential diagnosis for an articular pillar fracture?
asymmetric pillars
What are the most common levels of a clay shoveler fracture?
C6-T2
What is the mechanism of a clay shoveler fracture?
- flexion avulsion of SP (eg. shoveling wet snow, squats w/ wt on spine)
- direct impact
What is the stability of a clay shoveler fracture?
stable
(heals non-union)
What are the radiographic findings of a clay shoveler fracture?
“double spinous” sign on AP view (SP displaces inferiorly)
What is the differential diagnosis for a clay shoveler fracture?
nuchal bone
What is the diagnosis?
Articular pillar Fx
What is the diagnosis?
Burst Fx
What is the diagnosis including spinal level?
Clay shoveler Fx at C4 and C7
What is the diagnosis?
Compression Fx
What radiographic sign is present?
“Double spinous” sign
(Dx: clay shoveler Fx at C6)
