Clinical Back

Question 1

Answer 1

• Green = anterior longitudinal ligament
• Red = posterior longitudinal ligament
• Blue = supraspinous ligament (and nuchal in cervical region)

Question 2

Answer 2

Question 3

name the types of odontoid fractures

Answer 3

• Type 1: fracture of the upper part of the odontoid peg
  
  • rare and potentially unstable
• type II: fracture at the base of the odontoid
  
  • unstable and has high risk of non-union
• type III: through the odontoid and into the lateral masses of C2
  
  • best prognosis for healing

Question 4

Answer 4

Question 5

describe Hangman’s fracture

Answer 5

• the fracture occurs in the bony column formed by the superior and inferior articular processes of the axis, the pars interarticularis
• traumatic spondylolysis of C2 occurs as a result of hyperextension of the head + neck

Question 6

describe the Jefferson Burst fracture

Answer 6

• occurs at C1 (atlas)
  
  • cause: compression from above
• does not necessarily result in spinal cord injury since dimensions of the bony ring increase
• vertebra C1 is a bony ring with 2 wedge-shaped lateral masses, connected by relatively thin anterior and posterior arches and a transverse ligament.
  
  • because the taller side of the lateral mass is directed laterally, vertical forces compressing the lateral masses between the occipital condyles and the axis drive them apart, fracturing one of both of the anterior or posterior arches

Question 7

describe the x-rays

Answer 7

Question 8

Answer 8

wedge/compression fracture

wedging of the L1 vertebrae

Question 9

describe a wedge/compression fracture

Answer 9

• wedge fracture is a vertebral compression fracture occurring anteriorly and/or laterally
• wedge fractures are considered serious when the fracture affects adjacent vertebrae or the anterior weding is >50%

Question 10

Answer 10

Question 11

describe a chance fracture

Answer 11

• transverse fracture through the vertebra (may include spinous process) with anterior compression of vertebral body
• the most common site is at the T12-L2 vertebral levels
• it is mainly caused by sudden forward flexion (lap seatbelt injury)

Question 12

describe a burst fracture

Answer 12

• injury to the spine in which the vertebral body is severely compressed
• burst = margins of the vertebral body spread out in all directions

Question 13

describe spondylolysis

Answer 13

• fracture of the column bones connecting the superior and inferior articular processes (pars interarticularis)

Question 14

describe the types of spina bifida

Answer 14

• spina bifida occulta
  
  • failure of the embryonic halves of the neural arch to fuse
• spina bifida cystica
  
  • memingocele = cyst like sac composed of the meningeal membranes + CSF
  • meningomyelecele = cyst with spinal cord + nerve roots
  • associated with meroencephaly or anencephaly