Ch 7 - SCI: Spinal Pathology Flashcards by Carmel@Brainscape AdminPro

What is the MOI of cervical compression fractures?

Cervical flexion with axial loading ruptures the plates of the vertebra and
compresses the body

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What is the most common cervical compression fracture?

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What is seen on xray in cervical compression fractures?

Anterior wedge-shaped appearing vertebra

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What is the MOI of cervical unilateral facet joint dislocations?

Cervical flexion-rotation injury

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When are cervical facet joint dislocations considered unstable?

Posterior longitudinal ligament (PLL) is disrupted

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What is seen on xray in unilateral facet joint dislocations?

Vertebral body <50% displace

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What is the most common level in unilateral and bilateral facet joint dislocations?

C5–C6

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What is the MOI of cervical bilateral facet joint dislocations?

Flexion injury

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What is seen on xray in bilateral facet joint dislocations?

Vertebral body >50% displaced causing significant narrowing of the spinal canal

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What is the most common level in hyperextension injuries?

C4-C5

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What are the MCC of non-traumatic SCI in US?

Spinal stenosis with myelopathy

Spinal cord tumors

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Who is MC affected by epidural abscess?

Diabetic and immunocompromised patients

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What is the time frame to develop Radiation myelopathy?

Months to years after treatment

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What is the clinical presentation of Radiation myelopathy?

Weakness
Loss of sensation
Sometimes Brown-Séquard-like syndrome
Prognosis for recovery is poor

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What are the majority of spinal cord tumors?

Metastatic in origin, and 95% of these are extradural

70% of spinal metastases occur in the thoracic spine

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What is the clinical presentation of spinal cord tumors?

Pain worse at night and in the supine position

What are the MC sources of secondary spinal cord tumors?

Breast
Lung
Prostate

What are the MC primary spinal cord tumors?

Ependymomas

Astrocytoma

What is the order of least to most restrictive cervical orthoses?

Soft collar 
Philadelphia collar
SOMI brace
Four poster
Minerva brace
Halo collar

When are complete lesions MC seen?

– Bilateral cervical facet dislocations
– Thoracolumbar flexion-rotation injuries
– Trans-canal gunshot wounds

When are incomplete lesions MC seen?

– Cervical spondylosis (falls)
– Unilateral facet joint dislocations
– Noncanal penetrating gunshot/stab injuries

What is a Jefferson fracture?

Burst fracture of the C1 ring. Usually a stable fracture with no neurological findings

What is the MOI of a Jefferson fracture?

Axial loading causing fractures of anterior and posterior parts of the atlas (i.e., football spearing)

What is the treatment of a Jefferson fracture?

Stable: Rigid orthosis (Halo vest)
Unstable: surgery

What is a Hangman fracture?

C2 burst fracture

What is the MOI of a Hangman fracture?

Usually bilateral from an abrupt deceleration injury (e.g., MVC with head hitting windshield) Most often stable with only transient neurological findings

What is the treatment of a Hangman fracture?

Stable: Rigid orthosis (Halo vest) Unstable: surgery

Describe a Type I Ondontoid (dens) fracture.

Fracture through the tip of dens | No treatment usually required

Describe a Type II Ondontoid (dens) fracture.

Most common Fracture through the base of odontoid at junction with the C2 vertebra Treated with a Halo

Describe a Type III Ondontoid (dens) fracture.

Fracture extends from base of odontoid into the body of the C2 vertebra Treated with a Halo

What is a Chance fracture?

Transverse fracture of the thoracic or lumbar spine from posterior to anterior through the spinous process, pedicles, and vertebral body

What is the MOI of a Chance fracture?

Lap seat belts Falls Crush injury w/ acute hyperflexion of thorax

What is the MOI of a Vertebral Body Compression fracture?

Axial compression with or without flexion

What is a Dowager hump?

Thoracic kyphosis

Who is Spinal Cord Injury without radiologic abnormality (SCIWORA) seen in?

Young children | Older adults

What is the MOI of Spinal Cord Injury without radiologic abnormality (SCIWORA) in Children?

■ Traction in a breech delivery | ■ Violent hyperextension or flexion

What are predisposing factors of Spinal Cord Injury without radiologic abnormality (SCIWORA) in Children?

■ Large head-to-neck size ratio ■ Elasticity of the fibrocartilaginous spine ■ Horizontal orientation of the planes of the cervical facet joints

What is the MOI of Spinal Cord Injury without radiologic abnormality (SCIWORA) in Adults?

■ A fall with hyperextension of the neck, leading to an acute central cord syndrome ■ Ligamentum flavum may bulge forward into the central canal and narrow the sagittal diameter as much as 50%