Unstable spine fractures: Difference between revisions
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**Ligament flavum | **Ligament flavum | ||
**Posterior elements | **Posterior elements | ||
===Examples of Unstable Cervical Spine Fractures=== | |||
*[[Jefferson's fracture]] | |||
*Bilateral [[Cervical facet dislocation]] | |||
*[[Odontoid fracture]], type II or III | |||
*[[Atlanto-occipital dissociation]] | |||
*[[Hangman's fracture]] | |||
*[[Flexion teardrop]] | |||
*''Mnemonic: "Jefferson Bit Off A Hangman's Thumb"'' | |||
==Clinical Features== | ==Clinical Features== | ||
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*III:Always unstable | *III:Always unstable | ||
== | ==Evaluation== | ||
*CT with reconstructions | *CT with reconstructions | ||
*Consider plain x-ray in conjunction as this is what is used during orthospine | *Consider plain x-ray in conjunction as this is what is used during orthospine follow up | ||
*MRI to assess cord and ligament damage | *MRI to assess cord and ligament damage | ||
==Management== | ==Management== | ||
{{Unstable cervical spine fracture management}} | |||
==Disposition== | |||
==See Also== | ==See Also== | ||
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*[[Fractures (Main)]] | *[[Fractures (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Trauma]] | |||
[[Category:Neurology]] | |||
[[Category:Orthopedics]] | |||
Latest revision as of 13:41, 23 August 2017
Background
Denis' three column concept helps to determine whether a vertebral fracture is stable or unstable
- I: Anterior column
- Anterior longitudinal ligament
- Anterior 1/2 of the vertebral body and disk
- II: Middle column
- Posterior 1/2 of the vertebral body and disk
- Posterior longitudinal ligament
- III: Posterior column
- Facet joints
- Ligament flavum
- Posterior elements
Examples of Unstable Cervical Spine Fractures
- Jefferson's fracture
- Bilateral Cervical facet dislocation
- Odontoid fracture, type II or III
- Atlanto-occipital dissociation
- Hangman's fracture
- Flexion teardrop
- Mnemonic: "Jefferson Bit Off A Hangman's Thumb"
Clinical Features
- I:Always stable
- II:Possibly unstable
- III:Always unstable
Evaluation
- CT with reconstructions
- Consider plain x-ray in conjunction as this is what is used during orthospine follow up
- MRI to assess cord and ligament damage
Management
- C-collar
- Consult ortho or spine as needed
Disposition
See Also
- Cervical Spine Injuries
- Spinal Cord Trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
- C-spine (NEXUS)
- C-Spine X-Ray
- Fractures (Main)