Vertebral Coloumn Fractures Flashcards
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Functional Spinal Unit
Vertebral bodies
IV discs
Facet joints
Strong ligamentous structures
3 column theory of stability
Anterior column
Anterior longitudinal lig.
Anterior 2/3 of vertebral body and annulus
3 column theory of stability
Middle column
Posterior 1/3 of vertebral body
Posterior longitudinal ligament
3 column theory of stability
Posterior column
Ligamentum flavum
Pedicles
Facets
Spinous processes
Posterior ligaments (interspinous, supraspinous)
Typical fracture patterns of the cervical spine
Occipitocervical
Atlanto-axial instability
- dense held in position by string transverse ligament
Atlas fracture
- axial compression force
- anterior/posterior arches
- burst fracture
In a cervical spine fracture what do you see on the lateral X-ray
ADI less than 3 mm
What do you see on an AP open mouth odontoid X-ray when evaluating a cervical spine fracture
The lateral mass displacement
Operation for cervical spine fracture
Posterior C1 and C2 Fusion
Hangman’s fracture
Traumatic Spondylolisthesis of C2
Bilateral oars interarticularis fractures of C2
Hyperextension distraction type injuries
High incidence of cord injury
Indication for ORIF for a hangman’s fracture
More than 5mm displacement and severe angulation
Trauma to the thoracic spine above the level of the conus may result in
Complete spinal cord lesions
Trauma distal to the conus medullaris or level L1 may result in
Nerve root injury
Do you know if an injury to the thoracolumbar spine is stable?
If the middle column is intact
Causes of pathological fractures
Infection
Metastasis
Primary bone tumor
Metabolic- age, osteoporosis
