Vertebral Fractures

Question 1

What are the causes of vertebral fractures?

Answer 1

Major Trauma

Minor Trauma

Question 2

What is involved with major trauma of vertebral fractures?

Answer 2

MVAs
Falls
Diving injury
Sports

Question 3

What is involved with minor trauma of vertebral fractures?

Answer 3

Osteoporosis
Tumors
Infections
Long term steroid use

Question 4

What should be expected in a cervical spine fracture?

Answer 4

ALWAYS suspect in
TBI
Unconscious
Intoxicated patients

Question 5

What is the presentation of vertebral fractures?

Answer 5

MOI specific

Question 6

What are the s/s of vertebral fractures?

Answer 6

• Severe neck or back pain
• Paraspinous muscle spasm
• Bony tenderness
• +/- neurologic defects- weakness, N/T

Question 7

What are the PE of vertebral fractures?

Answer 7

Swelling
Ecchymosis
TTP- bony and muscular
Gap/step-off between vertebra
Motor and sensory function
Perianal sensation
Sphincter tone

Question 8

What imaging is used cervical vertebral fractures?

Answer 8

Plain xray

• AP
• Lateral odontoid view

Question 9

What is a jefferson fracture?

Answer 9

Burst of C1

Question 10

What is a hangman’s fracture?

Answer 10

Hyperextension injury

Bilateral fracture of C2 pedicles

Question 11

What is a clay-shovelers fracture?

Answer 11

Spinous process avulsion

C7> C6> T1

Question 12

What is the treatment of cervical vertebral fractures?

Answer 12

IMMOBILIZATION

Methylprednisolone 30 mg/kg bolus followed by drip 5.4mg/kg/h x 23 hrs

Conservative vs surgical intervention

Question 13

What are the goals of treating a vertebral fracture?

Answer 13

Preventing neurologic injury

Restoring Stability

Restoring normal function