Ch. 8 Cervical and Thoracic Spine Pathology

Question 1

fracture of the spine produced by compression - wedge shaped appearance of vertebral body

Answer 1

compression fracture

Question 2

abnormal lateral curvature of the spine

Answer 2

scoliosis

Question 3

metabolic bone disorder resulting in demineralization of bone - commonly seen in post-menopausal women

Answer 3

osteoporosis

Question 4

gradual degenerative changes to spine associated with aging

Answer 4

degenerative disk disease

Question 5

“swayback”, the lumbar curvature is exaggerated - may be caused by pregnancy, extreme obesity, poor posture, rickets or tuberculosis of the spine (increased concavity)

Answer 5

lordosis

Question 6

“humpback”, abnormal thoracic curvature (increased convexity) caused by poor posture, rickets, or tuberculosis of the spine

Answer 6

kyphosis

Question 7

the result of acute hyperextension of the head on the neck, appears as a fracture of the arch of C2 anterior to the inferior facet and is usually associated with anterior subluxation of C2 on C3

Answer 7

hangman’s fracture

Question 8

this fracture, which results from hyperflexion of the neck, results in avulsion fractures on the spinous processes of C6 through T1. The fracture is best demonstrated on a lateral cervical spine radiograph

Answer 8

clay shoveler’s fracture

Question 9

frequently associated with osteoporosis, and often involves collapse of a vertebral body, which results from flexion or axial loading most often in the thoracic or lumbar regions. Also can result from severe kyphosis caused by other diseases. Anterior edge collapses, changing the shape of the vertebral body into a wedge instead of a block. It induces kyphosis and may compromise respiratory and cardiac function, also frequently results in injury to the spinal cord. Best demonstrated on a lateral projection of the affected region of the spine

Answer 9

compression fracture

Question 10

zygapophyseal joints in the cervical region can be disrupted during trauma. if the patient’s injury involves flexion, distraction, and rotation, only one zygapophyseal joint may be out of alignment, with a unilateral subluxation. Radiographically, the vertebral body will be rotated on its axis, creating a bowtie artifact on the lateral cervical spine image. If the patient’s injury involves extreme flexion and distraction, both right and left zygapophyseal joints on the same level can be disrupted, creating bilateral locked facets. Radiographically, the vertebral body will appear to have jumped over the vertebral body immediately inferior to it. In either case, the spine is not stable because the spinal cord is distressed by this manipulation. Following the AP and lateral projections of the cervical spine, CT scanning of the spine generally is indicated

Answer 10

facets - unilateral subluxation and bilateral locks

Question 11

this fracture extends through the pedicles of C2, with or without subluxation of C2 on C3. This cervical fracture occurs when the neck is subjected to extreme hyperextension. The patient is not stable because the intact odontoid process is pressed posteriorly against the brainstem. A lateral projection of the cervical spine will demonstrate the anterior displacement of C2 characteristic

Answer 11

hangman’s fracture

Question 12

if the soft inner part (nucleus pulposus) of an intervertebral disk protrudes through the fibrous cartilage outer layer (annulus) into the spinal canal, it may press on the spinal cord or spinal nerves, causing severe pain and possible numbness that radiate into the extremities. This condition sometimes is called a slipped disk. This is well demonstrated by MRI of the cervical spine region, but more frequently involves levels L4-L5

Answer 12

herniated nucleus pulposus (HNP)

Question 13

this comminuted fracture (splintered or crushed at a site of impact) occurs as a result of axial loading, such as that produced by landing on one’s head or abruptly on one’s feet. The anterior and posterior arches of C1 are fractured as the skull slams onto the ring. The AP open mouth projection and lateral cervical spine projection will demonstrate this fracture

Answer 13

Jefferson fracture

Question 14

this condition is an abnormal or exaggerated convex curvature of teh thoracic spine that results in stooped posture and reduced height. It may be caused by compression fractures of the anterior edges of the vertebral bodies in osteoporotic patients, particularly postmenopausal women. It also may be caused by poor posture rickets, or other diseases involving the spine (Scheuermann disease). A lateral projection of the spine best demonstrates the extent

Answer 14

kyphosis

Question 15

this fracture involves the dens and can extend into the lateral masses or arches of C1. An AP open mouth projection will demonstrate any disruption of the arches of C1

Answer 15

odontoid fracture

Question 16

this type of arthritis is characterized by degeneration of one or many joints. In the spine, changes may include bony sclerosis, degeneration of cartilage, and formation of osteophytes (bony outgrowths)

Answer 16

osteoarthritis

Question 17

this condition is characterized by loss of bone mass. Bone loss increases with age, immobilization, long-term steroid therapy, and menopause. The condition predisposes individuals to vertebral and hip fractures. Bone densitometry is a relatively low-dose imaging modality for measuring the degree of osteoporosis.

Answer 17

osteoporosis

Question 18

a relatively common disease of unknown origin that generally begins during adolescence, it results in the abnormal spinal curvature of kyphosis and scoliosis. It is more common in males than females. Most cases are mild and continue for several years, after which symptoms disappear but some spinal curvature remains

Answer 18

Scheuermann disease

Question 19

although many individuals, normally have some slight lateral curvature of the thoracic spine, an abnormal or exaggerated lateral curvature of the spine is called this. It is most common in children between 10-14, and is more common in females. It may require the use of a back brace for a time, until the condition of vertebral stability improves. This deformity, if severe enough, may complicate cardiac and respiratory function. Effects are more obvious if it occurs in the lower vertebral column, where it may create tilting of the pelvis with a resultant effect on the lower limbs, producing a limo or uneven walk

Answer 19

scoliosis

Question 20

this condition is inflammation of the vertebrae

Answer 20

spondylitis

Question 21

the characteristics of this condition is neck stiffness due to age-related degeneration of intervertebral disks. the condition can contribute to arthritic changes that may affect the zygapophyseal joints and intervertebral foramen

Answer 21

spondylosis

Question 22

the mechanism of injury is compression with hyperflexion in the cervical region. The vertebral body is comminute, with triangular fragments avulsed from the anteroinferior border and fragments from the posterior vertebral body displaced into the spinal canal. Neurologic damage (usually quadriplegia) is a high probability. Based on the extent of the fracture and possible spinal cord involvement, CT scanning usually is indicated once a baseline lateral and AP projections of the cervical spine have been taken

Answer 22

teardrop burst fracture

Question 23

an incidental finding that occurs when the vertebra takes on a characteristic of the adjacent region of the spine. This occurs most often in the lumbosacral region in which the vertebrae possess enlarged transverse processes. Another example involves the cervical and lumbar ribs. A cervical rib is a rudimentary rib that projects laterally from C7 but does not reach the sternum. A lumbar rib occurs as an outgrowth of bone extending from the transverse process(es) of L1

Answer 23

transitional vertebra