Spine Flashcards
Jefferson Fracture
Burst fracture of C1 Atlas
-caused by axial loading of head on spine
Otontoid Fracture
Fracture of Otontoid C2
Hangman’s Fracture
Fracture of posterior aspects of C2
Hyper- extension mechanism- falls, MVA’s
Often spinal cord compromise
subluxation of C2 over C3
Clay shovelers Fracture
Fracture of spinous process of C6,7,T1 or T2
Hyperflexion injury or direct trauma
When possible spinal cord injury: what signs and symptoms require immediate transports to ER?
-Severely painful neck ROM or a significant decrease in ROM
-unconsciousness or altered level of consciousness
-bilateral neurologic findings or complaints,
-significant midline spine pain with or without palpation
-obvious spinal column deformity.
In case of a spinal cord injury, what is vital to do after stabilize spine?
remove face mask to provide immediate access to airway
What is the first step in any emergency scene?
assess area for safety
The MOST appropriate age range to target for screening of scoliosis is
11-14 years
COOK CERVICAL MYELOPATHY CPR
- Gait deviation: which shows as abnormally wide-based gait, ataxia, or spastic gait
- A positive Hoffmann’s sign: This test is characterized by a reflex contraction of the thumb and index finger when flipping the distal part of the middle finger.
- An inverted supinator sign: which is elicited by quick tapping near the styloid process of the radius, the attachment of the brachioradialis tendon. It shows in finger flexion or slight elbow extension.
- A positive Babinski sign: This sign shows as extension of the big toe and fanning of the other four toes when stroking the lateral aspect of the foot sole from the heal forwards towards the great toe.
- Age >45 years old
IF 3/5 POSITIVE; + LR IS 30.9
IF 1/5 POSITIVE; - LR is 0.18
Athletes with fractures that are healed and stable can return to play if they demonstrate:
- Normal and pain-free cervical ROM
⁃ Normal muscle strength
⁃ Normal neurological exam
What are contraindications for return to contact sport after cervical fractures?
-Permanent neurological injury
-Multilevel cervical fusion
-Fusion involves either C1-C2 or C2-C3
Burners/Stingers Return to Play Rules
- First-time injuries:
May return to the same game once symptoms have resolved - Second injury in the same season
Can return for the next game if symptoms are resolved and neurological testing is normal - Three or more stingers in the same season
Medical examination including imaging
May consider holding out for the rest of the season
Burner/Stinger immediate management:
Only AROM within pain tolerance should be performed.
Proper sideline assessment should include
-AROM,
-palpation for muscular spasm or bony tenderness, -neurological assessment emphasizing the C5–C7 myotomes.
These are the cervical levels that are typically associated with stingers.
What should rehab for Stingers include?
-C/S lateral glide mobiliations,
-posterior shoulder girdle strengthening,
-deep neck flexor strengthening.
**cervical mobilizations have been shown to reduce symptoms immediately following intervention and would therefore be the most appropriate for the athlete initially.
spondylolyisis
-bony defect within the pars interarticularis of the vertebral arch.It presents as a weakness or fracture at this point. The vast majority of spondylotic defects are seen at level L5 (85-95%), with level L4 being the second most likely to be affected
-insidious onset,
-low back pain that is exacerbated with activity or lumbar hyperextension, and
-may or may not be associated with a radicular component
-hyper-lordotic curve
-limited ROM,
-pain over affected segment
