In 1793 discussion on the stability of spinal fracture dislocations was first mentioned. The topic cervical spine fracture you are seeking is a synonym, or alternative name, or is closely related to the medical condition cervical fracture. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlantoaxial dislocations, fractures of the odontoid process, and hangmans fractures in the c2. This process is experimental and the keywords may be updated as the learning algorithm improves. Cervical fractures can occur due to a flexion, flexionrotation, extension, extensionrotation, vertical compression, or lateral flexion injury. Jun 18, 2017 this feature is not available right now. A cervical fracture is a break or crack that occurs in one of the three vertebral columns of the spine, called the cervical vertebrae. Trauma clinical guideline cervical spine injury evaluation. One third of cervical fractures occur at the c2 level and one half occur at c6 or c7. Gravity depends on the location, stability, and pattern of the injury. Males are affected more commonly than females with the median age of injury being 56 years.
Nerves in the spinal cord control your ability to move. Injuries of the subaxial cervical spine c37 are among the most common and potentially most devastating injuries involving the axial skeleton. Cervical spine fractures musculoskeletal medicine for. Your spine runs from the base of your skull to your pelvis. Original article classification and surgical management for the axis fracture complicated with adjacent segment instability lei wang 1, chao liu2, qinghua zhao, jiwei tian1 1department of orthopedics, first peoples hospital affiliated to shanghai jiaotong university, no. Fractures and dislocations of the cervical spine are not uncommon and account for almost half of all spinal column injuries that occur every year.
Injuries of the cervical spine are by far the ones most. Cervical spine injury classification system slic in 2007 to combine. Cervical spine fractures muhamma authorstream presentation. Other common causes include disc herniation, spinal stenosis, trauma, and spinal tumors. Trauma clinical guideline cervical spine injury evaluation the trauma medical directors and program managers workgroup is an open forum for designated trauma services in washington state to share ideas and concerns about providing trauma care. Mar 16, 2016 epidemiology of cervical spine fractures csfx in trauma patients of general population is not yet exclusively known. Screening via ct angiogram after traumatic cervical spine. A fracture, or break, in one of the cervical vertebrae is commonly called a broken neck. The purpose of this study was to evaluate the epidemiology of csfx in trauma patients.
Describe the optimum management of transport of the young child with an injured cervical spine 4. In the lower cervical spine, fractures follow the same pattern as in other segments of the. Cervical spine fracture evaluation clinical presentation. On sidebyside comparison, 14 more lesions were found on t2wfse images, but no more lesions were found on merge images.
Definitions, mechanisms, and radiographs and evaluation of. Fractures of the cervical spine are potentially serious and devastating if not properly treated. The national emergency xradiography utilization study criteria or the canadian cervicalspine rule criteria can be used to identify lowrisk patients who do not need cervical spine imaging. When separately evaluated, 79 lesions were found on merge images and 32 on t2wfse images. The subaxial cervical spine injury classification system slic. The vertebrae of the lower cervical spine have a superior cortical surface which is concave in the coronal plane and convex in the sagittal plane. The majority of fractures and dislocations of the spinal column occur in the cervical spine because it is the most mobile portion of the spinal column, and understandably, the most vulnerable to injury. Anteroinferior t1 vertebral body fracture with all disruption. Examples of common causes in humans are traffic collisions and diving into shallow water. Aug 01, 2008 computed tomography can demonstrate cervical spine fractures, including significant injuries, not shown by radiographs. Cervical spine fracture complications differ, depending on the degree of.
They represent a break in the cortex of the bone so the bone is in more than one piece. The workgroup meets regularly to encourage communication among services and to share best practices. Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. Abnormal movement of neck bones or pieces of bone can cause a spinal cord injury resulting in loss of sensation, paralysis, or usually instant death. These fractures are characterized based on specific classifications. A cervical fracture is a break in a vertebra bone in your neck. Computed tomography can demonstrate cervical spine fractures, including significant injuries, not shown by radiographs. Ct with contrast myelography has an accuracy approaching 96% for diagnosis of cervical disc herniation. Cervical spine injuries, fractures and whiplash multiple. Current protocols for evaluation of suspected cervical spine injury combine information from the history, clinical examination and radiographic evaluation to. Cervical cord is expanded with edema and multifocal contusions from c2 to c7. The most common cause of accident was a highenergy fall 39%, followed by traffic accidents 26. Basic imaging consists of plain xrays of the cervical spine in two planes. Click canadian cspine rules or nexus to determine when radiograph truly is needed.
Nov 09, 20 normal anatomy lower subaxial cervical spine. Cervical spine injuries, fractures and whiplash multiple facet joint ruptures and fractures written by wolfgang rauschning, md multiple facet joint ruptures and fractures of the transverse processes from c4 to c6. Types of fractures most spinal fractures can be classified into 4 main types, including. In a study of surgical residents ability to predict cervical injuries on the basis of clinical examination alone, sensitivity and specificity were 46% and 94%, respectively. In a smaller series, 1272 patients with significant craniocerebral injury had only a 1. Cervical spine fracture with vertebral artery dissection. Sixtyfive percent of all cervical spine fractures and 80% of the multisegmental injuries were accompanied by an associated injury. Pdf cervical spine fracture with vertebral artery dissection. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. There is a gradual change in the acceptability of halo jacket treatment for unstable cervical spinal injuries and much as the management of tibial fractures has migrated from a nonoperative treatment approach to operative stabilisation, there is a similar shift in trends for managing unstable cervical spine injuries. Original article classification and surgical management for. Cervical spine injuries, fractures and whiplash multiple facet joint ruptures and fractures written by wolfgang rauschning, md multiple facet joint ruptures and fractures of. Pitfalls and complications in the treatment of cervical spine.
Lower cervical spine fractures and dislocations clinical. Cervical spine fractures and osteoporosis springerlink. Pdf surgery for cervical spine injury associated with vertebral. Cervical spine fractures and dislocations usc spine center. Basic principles of management for cervical spine trauma. Wedge fractures a compression fracture in which the front part of the vertebral body is crushed, forming a wedge shape.
These were subsequently treated with anterior diskectomy and plating. Imaging of suspected cervical spine injury see imaging of adults with suspected cervical spine injury. While fall related fractures were evenly distributed over the whole spine, traffic accidents induced significantly more fractures of the cervical and thoracic spine. Results were then sequentially merged with various key words related to cervical trauma, injury classification, and terms for fracture patterns. Spinal complications associated with this disease included scoliosis, thoracolumbar compression fractures, and other spinal fractures, cervical spondyloptosis, and basilar invagination. Classification and surgical management for the axis fracture. Discuss the anatomical features of the childs cervical spine which result in the pattern of injury recorded 3. Depending on where along your spine you have fractured and the number of spinal fractures you have, this will affect where the pain is felt and how you are treated. Management of acute cervical compression fractures in two pa.
The cervical spine is susceptible to injury because it is highly mobile with relatively small vertebral bodies and supports the head which is both heavy and acts as a lever. Most of the time, they are associated with major trauma and carry the risk of damage. Cervical vertebrae support your head and allow your neck to bend and twist. A vertebral fracture is a break to one of the bones in your spine. Pdf surgery for cervical spine injury associated with vertebral body fracture cervical vertebral body fracture is the result of cervical flexion with. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlantoaxial dislocations, fractures of the odontoid process, and hangmans fractures in the c2 segment. Combined flexionextension cervical spine fractures with. Prospective unblinded cspine evaluation 667 trauma patients blunt trauma 99% average age was 35. Intact posterior elements are necessary for successful posterior wiring. Osteoporosis as a generalized bone disease appears to affect the cervical spine differently from other spinal regions. The risk of sustaining neurological deficits in this patient population is higher than average. The literature on the diagnosis, classification, and treatment of. Aug 18, 2017 clinical evaluation of the cervical spine in a patient with blunt trauma is unreliable.
Aug 22, 2009 there is a gradual change in the acceptability of halo jacket treatment for unstable cervical spinal injuries and much as the management of tibial fractures has migrated from a nonoperative treatment approach to operative stabilisation, there is a similar shift in trends for managing unstable cervical spine injuries. Subaxial cervical spine injury classification slic injury morphology points compression burst 1 1 distraction 3 translation rotation 4 total max 4 dlc status points intact 0 intermediate 1 disrupted 2 total max 2 neuro status points intact 0 nerve root deficit 1 complete cord injury 2 incomplete cord injury 3 addon. Describe the incidence and pattern of cervical spine fractures in children 2. A cervical fracture, commonly called a broken neck, is a catastrophic fracture of any of the seven cervical vertebrae in the neck. This configuration allows flexion, extension, and lateral tilt by gliding motion of the facets. Mechanism axial loading mva,diving 19 atlas fractures classification 1. Assume a cervical spine injury is present until proven otherwise in patients presenting to an emergency facility with a history of a highspeed motor vehicle accident, significant head or facial trau. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7 pathology.
Cervical spine fracture complications differ, depending on the degree of damage. The radiological imaging of spine fractures in patients with ankylosing spondylitis demands special attention since this injuries are frequently missed and delayed in their diagnosis 10, 1214, 20, 21. May 23, 2016 according to the university of southern california usc center for spine surgery, cervical spinal column fractures are relatively common and, together with cervical spine dislocations, represent around half of all spine injuries. This comprehensive, uptodate textbook of modern cervical spine surgery describes the standard and advanced techniques recommended by the cervical spine research society european section csrse with a view to enabling both young and experienced surgeons to further develop their skills and improve their surgical outcomes. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading epidemiology. Most of the time, they are associated with major trauma and carry the risk of damage to the spinal cord, including neurological deficits. The cervical spine is divided into the upper cervical spine occiputc2 and the lower cervical spine c3c7, according to anatomical differences. According to the university of southern california usc center for spine surgery, cervical spinal column fractures are relatively common and, together with cervical spine dislocations, represent around half of all spine injuries. Epidemiology of cervical spine fractures csfx in trauma patients of general population is not yet exclusively known.
The spinolaminar line joining the junctions of the lam. Prehospital see the naemsp national guidelines for spinal immobilization. Cervical spine fractures are potentially deadly conditions that arise after trauma, exaggerated extension or flexion. Compression injuries which are usually seen in the cervical spineknown. Pitfalls and complications in the treatment of cervical. May 06, 2019 injuries of the subaxial cervical spine c37 are among the most common and potentially most devastating injuries involving the axial skeleton. Dean and professor of surgery, university of toronto faculty of medicine toronto, ontario the recent revival of interest in the treatment of injuries of the spine has resulted from recognition that the adequate reduction of the displacement often leads to complete cure or at any rate to marked reduction in the residual dis. Management of acute cervical compression fractures in two. This can be done as an outpatient in a minimally invasive fashion. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.
High prevalence of concomitant fractures of c2 the unstable jefferson fracture is a c1 burst fracture with concomitant injury of the transverse atlantal ligament fourpart atlas fracture, with two in the posterior arch and two in the anterior arch. Fractures and dislocations of the cervical spine sciencedirect. Pearls and pitfalls accurate diagnosis of acute cervical spine injury requires cooperation between clinician and radiologist, a reliable and repeatable approach to interpreting cervical spine ct, and the awareness that a patient may have a significant and unstable ligamentous injury despite normal findings. Spine fractures are associated with a high incidence of concurrent noncontiguous spine fractures and spinal cord injuries. Cervical spine fractures radiology reference article. The seven bones in the neck are the cervical vertebrae. If you continue browsing the site, you agree to the use of cookies on this website. There is limited literature that addresses the management of acute cervical spine fractures in oi patients. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Spine trauma cervical spine injury following trauma can either be an isolated injury or one of a few complex injuries. Burst fractures when the vertebral body is crushed in all directions, potentially causing bone fragments to enter the spinal canal. Data from trauma patients admitted in the emergency.
Nbtp consensus statement clinical practice guideline for cervical spine injuries c. They support the head and connect it to the shoulders and body. Anatomy the ligaments allow for the wide rom of upper cspine while maintaining stability classified according to location with respect to vertebral canal internal. Vertebral fractures can occur in the cervical spine, the thoracic spine or the lumbar spine. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading. Cervical spine injury odontoid fracture surgical stabilization cervical spine fracture halo vest these keywords were added by machine and not by the authors. The ligamentum nuchae, an important ligament joining the interlaminal.
Cervical spine fractures, commonly known as broken neck, typically happen in highenergy traumas such as motor vehicle accidents, and account for the majority of fractures of the spinal column, as the cervical spine represents the part of the spine that is the most mobile and the most vulnerable to injury. Epidemiology of traumatic spine fractures sciencedirect. Spinal fusion, also called spondylodesis or spondylosyndesis, is a neurosurgical or orthopedic surgical technique that joins two or more vertebrae. Original article classification and surgical management. Tectorial membrane cruciate ligament including transverse ligament alar and apical ligaments external anterior and posterior atlanto. Atlas fractures 10% of all cervical spine injuries. Jefferson and hangman fractures formazionesostenibile. Stability of spinal fractures and fracture dislocations nature. Diagnosis and treatment of vertebral column metastases. Original article classification and surgical management for the axis fracture complicated with adjacent segment instability lei wang 1. Oct 01, 2019 the topic cervical spine fracture you are seeking is a synonym, or alternative name, or is closely related to the medical condition cervical fracture. Definitions, mechanisms, and radiographs and evaluation of thoracic and lumbar spinal column injury. This procedure can be performed at any level in the spine cervical, thoracic. Kalaivanan kanniyan slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.