Difference between revisions of "Unstable spine fractures"

(Management)
(Example of Unstable Fractures)
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==Example of Unstable Fractures==
 
==Example of Unstable Fractures==
 
*[[Jefferson's fracture]]
 
*[[Jefferson's fracture]]
*[[Bilateral facet dislocation]]
+
*Bilateral [[Cervical facet dislocation]]
 
*[[Odontoid fracture]], type II or III
 
*[[Odontoid fracture]], type II or III
*Any atlanto-axial or atlanto-occiptial fracture or dislocation
+
*[[Atlanto-occipital dissociation]]
 
*[[Hangman's fracture]]
 
*[[Hangman's fracture]]
*[[Flexion teardrop]]  
+
*[[Flexion teardrop]]
  
 
==Workup==
 
==Workup==

Revision as of 04:59, 2 January 2015

Background

Three-column-concept-2.jpg

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

Clinical Features

  • I:Always stable
  • II:Possibly unstable
  • III:Always unstable

Example of Unstable Fractures

Workup

  • CT with reconstructions
  • Consider plain x-ray in conjunction as this is what is used during orthospine f/u
  • MRI to assess cord and ligament damage

Management

  • C-collar
  • Consult ortho or spine as needed

See Also

Sources