Mod 4-5 Spine Fractures

Question 1

What are some causes of fractures and dislocations of the spine?

Answer 1

• Trauma
• Whiplash
• Stress in abnormal bone (Paget’s, osteoperosis, mets)

Question 2

What is the major goal in radiographing spine fractures?

Answer 2

Determine whether a fracture or dislocation is present and whether the injury is stable or unstable.

Question 3

What should all spine injuries be considered as?

Answer 3

As unstable, particularly cervical spine, until declared stable by a radiologist.

Question 4

Besides trauma, what else can cause dislocation or sublaxation?

Answer 4

Syndrome

*Most common one is cervical instability that is experienced by some Down syndrome patients.

Question 5

What is a sublaxation?

Answer 5

A partial or incomplete dislocation

Question 6

What is a luxation?

Answer 6

A complete dislocation

Question 7

Why is recognizing injury to the lower cervical spine important?

Answer 7

Because of the association between these injuries and spinal cord and nerve root injury.

Question 8

What is a Jefferson fracture?

Answer 8

A comminuted (composed of more than two fragments) of the ring of the atlas that involves both the anterior and posterior arches and causes displacement of the fragments.

Question 9

Whatis the characteristic appearance of the Jefferson fracture on an AP projection?

Answer 9

Lateral displacement of the lateral masses of C1 relative to the lateral masses of C2.

Question 10

What is the hangman’s fracture? List characteristics.

Answer 10

• Bilateral pedicle or pars interarticularis fractures involving the C2 vertebral body.
• Sublaxation of C2 vertebral body.
• Result of hyperextension of the head adn neck
• Commonly the result of automobile accidents where the face strikes the dashboard
• Or from a hanging

Question 11

What is the clay shoveler’s fracture?

Answer 11

• An avulsion fracture of a spinous process in the lower C Spine or upper T spine
• Often obscured by the shoulders in the cross table lateral
• Identifiable on teh AP as the “double spinous process sign”
• Represents a caudal displacement of the avulsed process

Question 12

What is the seat belt fracture?

Answer 12

Transverse fractue of a lumbar vertebra and is usually associated with significant internal organ damage.

Question 13

What can result as disks of the spine break down?

Answer 13

Herniation is possible with accompanying severe, acute or chronic pain often radiating into an extremity.

Question 14

Which vertebrae are often associated with herniated disks?

Answer 14

• L4 - L5
• L5 - S1

*Other major sites of involvement include C5/6 and C6/7 and T9-12 levels.

Question 15

How are herniated disks diagnosed (modalities)?

Answer 15

• Myelography
• CT
• MRI