Spine Trauma Flashcards
Minimum people for log rolll?
3
When should the cushion be placed under pt. head for spine trauma log roll?
never
Two groupings of SCI and what spinal levels they cover
Tetraplegia (C1-T1)
loss of sensation, function or movement in head, neck shoulders, arms, hands upper chest, pelvic organs and legs
Paraplegia-lost feeling or ability in the lower parts of the body. Chest, stomach, hips, legs, feet. Typically from T2-S5
If unconscious what is applied to a pt. neck
collar -> and CT C-spine is immediately requested.
CT Trauma spine protocol
Non-contrast
Bone and soft tissue window Axial, sagittal, coronal slices
Name the 4 spinal lines
- Anterior vertebral line 2. Posterior Vertebral line 3. Spinolaminar line 4. Interspinous line
Prevertebral ST swelling : abnormal ranges
C2 <7mm
C7 <20mm
Jefferson MOI
Axial loading / compression
Bilat facet joint D/C MOI
Flexion
Odontoid # MOI
Flexion/ extension
Atlanto/ occiptial or atlanto- axial D/C MOI
Flexion
hangmans C2 pedicular fracture MOI
Extension
Teardrop fracture MOI
flexion/ extension
Hyperflexion of neck injuries
– Compression and fragmentation of vertebral bodies
– Anterior subluxation
– Narrowed disc spaces
– Disrupted posterior vertebral line
– Widened interspinous process distance
Hyper extension of neck injuries
– Widened disc spaces
– Anterior ligaments ruptured
– Cord compression – central cord syndrome
typical axial compression fractures
burst
Jeffersons
Which odontoid fracture extends into body of C2?
type 3
Hangmans fracture appearance
Bilateral fractures through the pedicles of C2
* Anterior subluxation of C2 in relation to C3
flexion Teardrop # appearance
- Anterior tear drop fracture
- Anterior compression
- Anterior cord (Beck’s) syndrome
- Posterior distraction
- Extremely unstable
extension teardrop # appearancw
USUALLY HAS AVULSED ELEMENT FROM TORN ANT. LONGITUDINAL LIG.
* Avulsion of triangular fragment from anterior – inferior end plate * Usually C2
Burst fracture appearance
- Axialcompressionof vertebral body
- Bodyexpands
- Fracturefragments
move outwards - ?retropulsionof fragments into spinal canal -> cord injury
loss of vertebral height on AP
CT trauma C spine XAP
- AP+LateralScanogram
- Scanlimits:
– Base of skull (actually closer to EAM) to body of T3 - Bone(2mm)&ST(3mm)
reconstruction - Axial,Sagittal&coronal
main MI for T and L spine
– Hyperflexion
– Axial loading
– Shearing or Translation
– Hyperextension is uncommon
Common fractures in T spine and why?
– Wedge compression fractures – Burst fractures
– Fracture dislocations
Most # are flexion or axial due to ribs stopping rotatation
What does hyperlexion typically cause in T and L spine
anterior wedging
- Instability occurs when injuries affect ____ contiguous columns
2
common levels for T&L spine injuries
T9-L3
what long term condition can wedge compression in thoraco-lumbar spine cause?
Kyphosis
what is a chance fracture
- Flexion injury of vertebral body and distraction of the posterior elements
Anterior wedge fracture of the vertebral body with a horizontal fracture through posterior elements or distraction of facet joints and spinous processes.
best modality for SCI without radiological abnormality?
MRI
