Unstable spine fractures: Difference between revisions
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==Workup== | ==Workup== | ||
*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 | ||
Revision as of 21:56, 13 July 2016
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 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"
Workup
- 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
See Also
- Cervical Spine Injuries
- Spinal Cord Trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
- C-spine (NEXUS)
- C-Spine X-Ray
- Fractures (Main)