Cervical spine fracture

Question 1

What is the characteristic landmarks at each levels of the cervical spine starting from C2?

Answer 1

C2: mandible and bifid spinous process
C3: external jugular vein 
C4: hyoid bone 
C5: thyroid cartilage 
C6: cricoid cartilage

Question 2

What is the Nexus criteria and when is it used?

Answer 2

Assessing whether the individual has a cervical spine fracture without moving them. (NSAID)
N: neurological changes 
S: spinal tenderness
A: altered mental state (GCS)
I: intoxication 
D: distracting injury

Question 3

What are different types of flexion injuries?

Answer 3

anterior subluxation (hyperflexion sprain)
anterior wedge fracture
flexion teardrop fracture
bilateral facet dislocation

Question 4

What are different types of lateral flexion injuries?

Answer 4

Unilateral occipital condyle fracture

Lateral mass C1 fracture

Question 5

What are different types of extension injuries?

Answer 5

Hangman fracture
Extension tear drop fracture
Posterior arch C1 fracture

Question 6

What are short term complications from C5/6 cervical fracture?

Answer 6

Lungs: hypoventilation, difficulties breathing if diaphragm is affected
UL/LL: weakness and sensation, shoulder and elbow may be spared
LL: UMN signs
Urinary and faecal incontinence
Sexual dysfunction: loss of sympathetic from T10 to L2, loss of parasympathetic from S2-S4, loss of pudendal nerve supply

Question 7

What are long term complications from C5/6 cervical fracture?

Answer 7

Lungs: PE, pneumonia, DVT from immobility
Bladder: urinary catheter may be required
MSK: muscular atrophy
Neuro: neuropathic pain
Skin: pressure sores