Cervical spine injuries

Saturday, April 12, 2008

2 comments:

Anonymous said...: very useful.; April 15, 2008 at 3:50 AM
Anonymous said...: very good website, and i have learned many new things as a orthpaedic trainee and i recommend it to all the doctors in accident and emergency medicine.

MR ZEESHAN KAZI
FTSTA2 TRAUMA AND ORTHOPAEDIC SURGERY
QUEEN ELIZABETH HOSPITAL, GATESHEAD.; April 16, 2008 at 10:28 AM

Anatomy

1) TYPICAL -C3-C6
2) ATYPICAL-
-C1 (ATLAS)
-C2 (AXIS)
- C7(Vertebra Prominence)
3) A foramen, the foramen transversarium, in each transverse process of C1-C6 Transmits vertebral blood vessels
4) Typical cervical vertebrae (C3-C6) - Bodies are wider from side to side than from anterior to posterior; Vertebral foramina are triangular;
Spinous processes are bifid and short
5) C1 -Lacks a vertebral body - has an anterior arch instead
Lacks a spinous process - has a posterior tubercle instead
5) C2- Charecterestic Dens (odontoid process)- articulates with the anterior arch of the atlas
6) C7-Spinous process very long

Critical Appraisal Of lateral film

1) ALIGNMENT,
2) SOFT TISSUES,
3) ATLANTO-AXIAL REGION
4) DISCS AND JOINTS OTHER FILMS

Intervertebral spaces

DISCS AND JOINTS Unusual widening may indicate traumatic separation and instability

Stability

Whether the abnormality detected is stable or unstable.
Neurological :if a patient presents following a potential cervical spine injury and has had (no matter how transient or continues to have neurologic symptoms including paraesthesia, numbness, weakness, paralysis, then the cervical spine must be considered unstable.
Mechanical :in some of the patients no cervical spine fracture can even be seen, as the injury is entirely ligamentous, however, the cervical spine is unstable and must be treated as so.
collumns

Ant Collumn: Anterior longitudinal ligament(ALL)+ the anterior portion of the vertebral bodies + anterior portion of the annulus fibrosis
Mid column :posterior longitudinal ligament(PLL)+ the posterior portion of the vertebral body and annulus fibrosis Posterior column :posterior bony complex (posterior arch) + posterior ligamentous complex (supraspinous ligament+capsule+ ligamentum fla