clinical correlation

Question 1

Type of cervical vertebrae dislocation

Answer 1

1) Stage I: flexion sprain
2) Stage II: anterior subluxation w/ 25% anterior translation
3) Stage III: 50% translation
4) Stage IV: complete dislocation w/ “facet jumping” w/ locking of articular process.

Question 2

Fracture of the vertebral arch of the axis (C2)

Answer 2

Fracture of the vertebral arch of the axis (C2) is one of the most common injuries of the cervical vertebrae (40%)
• Usually occur in the bony column formed by superior and inferior articular processes of the axis traumatic spondylolysis of C2 caused by hyperextension of the head on the neck (aka hangman’s fracture)

• In severe injuries, the body of C2 vertebra displaced anteriorly respect to the body of C3 injury to spinal cord quadriplegia

Question 3

Fracture of the dens

Answer 3

Fracture of the dens (40-50% of axis injuries)
• Caused by horizontal blow to the head
• By complication of osteopenia (pathological loss of bone mass)

Question 4

Fracture of atlas

Answer 4

blow to the top of the head from a falling object or striking the bottom of the pool in a diving accident vertical forces compress the lateral masses between the occipital condyles and the axis drive them apart fracture one or both bony arches of the atlas (Jefferson or burst fracture).
If “burst” fracture + rupture of transverse ligament spinal cord injury.