MOD 8- C Spine - Injury Mechanisms & Cervical Trauma

These flashcards review spinal anatomy, injury mechanisms, specific cervical spine fractures, clinical presentations, treatments, and imaging considerations.

What are the three anatomical columns of the spine?

Anterior column (vertebral bodies, intervertebral discs, anterior longitudinal ligament); Middle column (posterior vertebral bodies/discs, vertebral foramen, pedicles); Posterior column (vertebral arch, transverse processes, facets, laminae, spinous processes).

Which spinal column determines injury stability?

The middle column—if intact the injury is stable; if disrupted it is unstable.

How are vertebral fractures classified?

By location (e.g., body, pedicles), type (e.g., compression, chip), and vertebral level (e.g., L3, T5).

What mechanisms of injury can cause spinal fractures or dislocations?

Hyperflexion, extension, compression, rotation, shearing, and distraction forces.

What injury does hyperflexion often cause?

Anterior wedge fractures or teardrop fractures.

What is a teardrop fracture and what causes it?

A severe anterior body fracture produced by hyperflexion with compression, commonly seen in motor-vehicle accidents.

What happens in spinal extension trauma?

The anterior longitudinal ligament is stretched; may produce avulsion fractures, torn discs, or fractures of spinous processes, laminae, or facets.

What are the outcomes of compression trauma to the spine?

Concave (end-plate) fractures or burst fractures that ‘explode’ the vertebral body.

What is the danger of a burst fracture?

Bony fragments may migrate toward the spinal cord, risking neurological damage.

What results from rotational trauma to the spine?

Ligament disruption and posterior element fractures, leading to fracture-dislocations.

What is shearing trauma and its risk?

A horizontal force across one spinal section that disrupts ligaments and can compress the spinal cord.

What is distraction trauma and what injuries can it cause?

Excessive stretching of the spine (opposite of compression) that can cause facet dislocation and fractures across both anterior and posterior elements.

What are the symptoms of a C1–C3 fracture?

Complete paralysis with no independent breathing; patient requires ventilatory support and suctioning.

What are the symptoms of a C4 fracture?

Head/neck movement and some shoulder movement; no arm, trunk, or leg movement; patient can breathe but needs assistance clearing secretions.

What movements are retained in a C5 injury?

Full head and neck motion, good shoulder motion, and elbow flexion; no trunk or leg movement.

What function is added in a C6 injury?

Elbow extension and improved elbow flexion.

What function is added in a C7 injury?

Partial finger movement and wrist flexion/extension.

What is a Jefferson fracture?

A burst fracture of C1 (atlas) caused by vertical compression.

What causes most C1 fractures?

Vertical compression injuries such as diving into shallow water or sports impacts.

How is a C1 fracture typically treated?

Cervical traction.

Where do dens (odontoid) fractures typically occur?

At the base of the odontoid process of C2.

What causes C2 (odontoid) fractures?

Severe flexion or extension injuries, often in unrestrained motor-vehicle passengers.

What are possible complications of C2 fractures?

Non-union due to poor blood supply and potential quadriplegia.

How are C2 fractures treated?

Cervical traction or surgical screw fixation.

What is a Hangman’s fracture?

A fracture of C2 in which the vertebral body separates from the neural arch.

What typically causes a Hangman’s fracture?

Hyperextension injuries, such as in motor-vehicle accidents or judicial hanging.

How is a Hangman’s fracture treated?

Immobilization with a halo vest or surgical stabilization, depending on severity.

What is a unilateral facet lock?

Displacement of the vertebral body by ≥25% due to flexion with rotation.

What is a bilateral facet lock?

Approximately 50% displacement of the vertebral body caused by flexion with severe distraction.

Which type of facet lock is more unstable?

Bilateral facet lock.

How are facet locks treated?

Closed reduction using cervical traction.

What is a Clay Shoveller’s fracture?

An avulsion fracture of a spinous process in the lower cervical or upper thoracic spine.

What causes Clay Shoveller’s fractures?

Sudden muscle contraction from activities such as shoveling, gardening, motor-vehicle accidents, or heavy lifting.

What are common symptoms of a Clay Shoveller’s fracture?

Neck or shoulder pain and decreased neck mobility.

Is there a neurological deficit associated with Clay Shoveller’s fractures?

No, neurological deficit is not typical.

What is the treatment for a Clay Shoveller’s fracture?

Rest and activity modification for 3–4 weeks; the fracture is considered stable.

What are common treatments for cervical spine injuries?

Cervical traction, halo vest immobilization, surgical screw fixation, and closed reduction techniques.

What imaging modality is preferred for suspected cervical spine injury after a motor-vehicle accident?

Computed tomography (CT) scan.

What clinical information is needed to adapt spine examinations?

Mechanism of injury, patient symptoms, stability and mobility of the spine, neurological status, and breathing ability.