Spine Trauma

Question 1

Minimum people for log rolll?

Answer 1

3

Question 2

When should the cushion be placed under pt. head for spine trauma log roll?

Answer 2

never

Question 3

Two groupings of SCI and what spinal levels they cover

Answer 3

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

Question 4

If unconscious what is applied to a pt. neck

Answer 4

collar -> and CT C-spine is immediately requested.

Question 5

CT Trauma spine protocol

Answer 5

Non-contrast
Bone and soft tissue window Axial, sagittal, coronal slices

Question 6

Name the 4 spinal lines

Answer 6

1. Anterior vertebral line 2. Posterior Vertebral line 3. Spinolaminar line 4. Interspinous line

Question 7

Prevertebral ST swelling : abnormal ranges

Answer 7

C2 <7mm

C7 <20mm

Question 8

Jefferson MOI

Answer 8

Axial loading / compression

Question 9

Bilat facet joint D/C MOI

Answer 9

Flexion

Question 10

Odontoid # MOI

Answer 10

Flexion/ extension

Question 11

Atlanto/ occiptial or atlanto- axial D/C MOI

Answer 11

Flexion

Question 12

hangmans C2 pedicular fracture MOI

Answer 12

Extension

Question 13

Teardrop fracture MOI

Answer 13

flexion/ extension

Question 14

Hyperflexion of neck injuries

Answer 14

– Compression and fragmentation of vertebral bodies
– Anterior subluxation
– Narrowed disc spaces
– Disrupted posterior vertebral line
– Widened interspinous process distance

Question 15

Hyper extension of neck injuries

Answer 15

– Widened disc spaces
– Anterior ligaments ruptured
– Cord compression – central cord syndrome

Question 16

typical axial compression fractures

Answer 16

burst
Jeffersons

Question 17

Which odontoid fracture extends into body of C2?

Answer 17

type 3

Question 18

Hangmans fracture appearance

Answer 18

Bilateral fractures through the pedicles of C2
* Anterior subluxation of C2 in relation to C3

Question 19

flexion Teardrop # appearance

Answer 19

• Anterior tear drop fracture
• Anterior compression
• Anterior cord (Beck’s) syndrome
• Posterior distraction
• Extremely unstable

Question 20

extension teardrop # appearancw

Answer 20

USUALLY HAS AVULSED ELEMENT FROM TORN ANT. LONGITUDINAL LIG.
* Avulsion of triangular fragment from anterior – inferior end plate * Usually C2

Question 21

Burst fracture appearance

Answer 21

• Axialcompressionof vertebral body
• Bodyexpands
• Fracturefragments
  move outwards
• ?retropulsionof fragments into spinal canal -> cord injury

loss of vertebral height on AP

Question 22

CT trauma C spine XAP

Answer 22

• AP+LateralScanogram
• Scanlimits:
  – Base of skull (actually closer to EAM) to body of T3
• Bone(2mm)&ST(3mm)
  reconstruction
• Axial,Sagittal&coronal

Question 23

main MI for T and L spine

Answer 23

– Hyperflexion
– Axial loading
– Shearing or Translation
– Hyperextension is uncommon

Question 24

Common fractures in T spine and why?

Answer 24

– Wedge compression fractures – Burst fractures
– Fracture dislocations

Most # are flexion or axial due to ribs stopping rotatation

Question 25

What does hyperlexion typically cause in T and L spine

Answer 25

anterior wedging

Question 26

• Instability occurs when injuries affect ____ contiguous columns

Answer 26

2

Question 27

common levels for T&L spine injuries

Answer 27

T9-L3

Question 28

what long term condition can wedge compression in thoraco-lumbar spine cause?

Answer 28

Kyphosis

Question 29

what is a chance fracture

Answer 29

• 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.

Question 30

best modality for SCI without radiological abnormality?

Answer 30

MRI