Xray of C3 Cervical spine vertebra over C4
dislocation C3 Vertebra Over C4
The vertebrae have been numbered for easier understanding.
Anteroposterior & Lateral Xrays Of Cervical Vertebrae Dislocation C5 Over C6
December 19, 2010 by Leave a Comment
A young male of 34 years was brought to casualty with history of fall from horse cart. He was quadriplegic [There was no power in any of the limbs]. On examination he was found to be in spinal shock.
The xray showed dislocation of C5 over C6 vertebra. Vertebrae have been marked for better understanding.
The neck was stabilized with head halter traction and he was put on supportive treatment.
His MRI revealed a compression at C5-C6 level along with cord edema. [Read more...]
Complications of Cervical Spine Surgery
June 25, 2010 by 24 Comments
Cervical spine surgery is a major surgical procedure and like every other surgical procedure has potential for complications. Te complications can be related to injury or type of surgery performed.
Postoperative Complications
Neurologic Deficit
Neurological deficit is most devastating complication of spine surgery. The cause could be an intraoperative event such as a direct spinal cord injury, posterior strut or graft displacement. Otherwise failure of the construct could be responsible.
A detailed examination is the key to identification of the problem and it should follow with plain radiographs. [Read more...]
Tear Drop Fractures of Lower Cervical Spine
May 1, 2010 by 14 Comments
Tear-drop fractures are recognized by their characteristic fracture pattern. These fractures involve anteroinferior portion of vertebral body and the fracture line is at an oblique angle to the body. It can be either extension tear drop or flexion teardrop depending on the mechanism of injury. [See images below]
An extension teardrop fracture occurs when there is hyperextension of the cervical spine. Hyperextension may cause the anterior longitudinal ligament to avulse the inferior portion of the anterior vertebral body at its insertion. The most common location is at C2.
In this case the height of the fragment usually exceeds its width. This fracture is more common in older patients with osteoporosis. The extension teardrop fracture is unstable in extension.
Similarly an extreme flexion can cause the flexion teardrop fracture. This may lead to impingement of the spinal cord due to extreme kyphosis caused by fracture. There is complete disruption of all ligamentous structures at the level of the injury. [Read more...]
Facet Fractures Without Dislocation In Lower Cervical Spine Injury
April 28, 2010 by Leave a Comment
Facet joints are articulations between two adjacent vertebrae. Two superior articular facets of lower vertebra and two inferior articular facets of higher vertebra form two facet joints. Thus each vertebrae participates in two superior and two inferior joints thus creating a chain of facet joints.
Majority of the fractures of facet joints are minimally displaced fractures which can be treated with non operative methods.
However, in some cases there may be present associated ligamentous disruption. These fractures are considered unstable. [Read more...]
Burst Fractures of Cervical Spine
April 27, 2010 by 1 Comment
Burst Fractures in cervical spine are result of high energy injury.
In a burst fracture a vertebra breaks with pieces of the vertebra shattering into surrounding tissues and sometimes the spinal canal. Burst fractures are most often caused by car accidents or by falls.
Burst fractures are known to produce severe deformity, severe canal compromise, loss of vertebral body height, and neurologic [Read more...]
Compression Fractures Of Lower Cervical Spine
April 25, 2010 by Leave a Comment
Simple compression fractures of the cervical spine vertebrae are fractures that involve anterior part of the vertebral body. In compression fractures, anterior portion of vertebral body fails due to compressive forces and the shape of vertebra becomes like a wedge.
Image Credit: http://faculty.washington.edu/alexbert/MEDEX/Winter/EM1DisordersSpine.htm
Xray
Anteroposterior view may appear normal or may show some decrease in height depending on severity of the compression. The lateral view shows decrease in anterior vertebral height due to compression and there is no involvement of posterior vertebral body. [Read more...]
Surgical Treatment of Cervical Spine Injuries – Options And Methods
April 23, 2010 by Leave a Comment
With increased choice of implants and gadgets and development of better surgical approaches & techniques, surgery is playing a greater role in management of cervical injuries as compared to earlier times.
Timing of Surgery
There is still controversy about the optimal time to perform surgery, particularly in patients with neurologic deficits. Advocates of early surgery point at the two benefits of earlier surgery
- Neurological recovery
- Improved ability to mobilize the patient without concern of spinal displacement.
Studies have pointed out that surgery performed within first 72 hours to 5 days have better outcome but surgery performed within first 24 hours may not. [Read more...]
Descriptive Classification of Lower Cervical Injuries
April 14, 2010 by Leave a Comment
In addition to the Allen’s classification of lower cervical spine injuries based on pattern of the injury, the lower cervical spine injuries can also be descriptive. This usually refers to the part of the cervical spine injured.
This descriptive classification divides the injuries into s vertebral body fractures, facet fractures, pedicle and lamina fractures, or anterior tension band disruption.
This classification is good for day to day communication and description of the injury. [Read more...]
Injuries To Lower Cervical Spine – An Overview
April 13, 2010 by Leave a Comment
C3-C7 would constitute lower cervical spine. Lower cervical spine fractures and dislocations are common injuries following major trauma.
Fractures of C6 and C7 account for nearly 40 percent of cervical spine injuries after blunt trauma.
Spinal cord damage is more frequently associated with lower cervical spine injuries than upper.
Age Distribution
Injuries most common in adolescents and young adults (15 – 24 years and middle-aged (>55 years)
Prehospital Care
The cervical spine injuries should be considered to be having cord injury untill ruled out. Moreover the cervical spine injury should be suspected in every major trauma.
Manual immobilization of the head and neck should be maintained until a hard cervical collar can be applied. [Read more...]
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