Upper Cervical Spine Trauma

Question 1

This may occur following upper respiratory tract infection (more common in children), or trauma. Patient presents w/torticollis, but unlike the normal type, the muscle spasm is on the LONG SCM side

Answer 1

Atlanto-axial rotary fixation

Question 2

This will show a “double lateral mass shadow” on lateral cervical x-ray

Answer 2

Atlanto-axial rotary fixation (AARF)

Question 3

Most common fracture of C1. MOI is axial compression and hyperextension. Fx occurs through sulcus for vertebral artery. Often assoc. w/SP fx in lower cervical spine

Answer 3

Posterior arch fx of C1

Question 4

Burst fracture of C1

Answer 4

Jefferson fracture

Question 5

Over _mm of offset of the lateral masses of C1 on C2 indicates tearing of the transverse ligament

Answer 5

8

Question 6

There are three classifications of dens fractures. The most common type, which is unstable, is a fracture through the base of the dens. This is type ___

Answer 6

2

Question 7

A fracture of the apex of the dens (rare and stable) is a type __, and a fracture of the dens that extends into the body of C2 (typically unstable) is type ___

Answer 7

1, 3

Question 8

Bilateral fracture through the pars interarticularis (of C2) - traumatic spondy. MOI is hyperextension. Often seen as a result of auto accidents when forehead strikes windshield.

Answer 8

Hangman fracture

Question 9

An Atlanto-axial subluxation (AAS) is almost always in what direction?

Answer 9

Anterior

Question 10

The lower limit of normal for the central canal at C1 is __mm

Answer 10

16

Question 11

Best view for visualizing a Jefferson fx (burst fx of C1)?

Answer 11

APOM

Question 12

Mechanism of injury for an anterior fx/dislocation of odontoid?

Answer 12

Hyperflexion (Posterior = hyperextension)

Question 13

A differential diagnoses for a type 1 odontoid process fx (tip of dens)?

Answer 13

Os terminale

Question 14

A differential diagnoses for a type 2 dens fx (through base of dens)?

Answer 14

Os odontoideum