Unstable spine fractures: Difference between revisions
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==Example of Unstable Fractures== | ==Example of Unstable Fractures== | ||
*Jefferson's fracture | *[[Jefferson's fracture]] | ||
*Bilateral facet dislocation | *[[Bilateral facet dislocation]] | ||
*Odontoid type II or III | *[[Odontoid fracture]], type II or III | ||
*Any | *Any atlanto-axial or atlanto-occiptial fracture or dislocation | ||
*Hangman's fracture | *[[Hangman's fracture]] | ||
*Flexion teardrop | *[[Flexion teardrop]] | ||
==Workup== | ==Workup== | ||
Revision as of 01:36, 2 January 2015
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
Clinical Features
- I:Always stable
- II:Possibly unstable
- III:Always unstable
Example of Unstable Fractures
- Jefferson's fracture
- Bilateral facet dislocation
- Odontoid fracture, type II or III
- Any atlanto-axial or atlanto-occiptial fracture or dislocation
- Hangman's fracture
- Flexion teardrop
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
- Cervical Spine Injuries
- Spinal Cord Trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
- C-spine (NEXUS)
- C-Spine X-Ray
- Fractures (Main)