This document discusses cervical spine pathology and injuries. It covers the anatomy of the cervical vertebrae and joints. It then describes three common types of cervical spine injuries: fractures, subluxations, and dislocations. It notes how the mechanism of injury relates to whether the injury is stable or unstable. Key cervical injuries mentioned include odontoid fractures, facet dislocations, and atlanto-occipital dislocations.
30. • Distraction with variable flexion and
extension
• Disruption of tentorial, apical, alar
ligaments
• Severe neurological deficits, often with
multi trauma
31.
32.
33. Axial load on straight C- spine
Force: Vertex → Occipital condyles → Lateral masses
of 𝐶1
58. • Odontoid fractures should not
be confused with
a) Os Odontoideum
b) Ossiculum terminale
Editor's Notes
No vertebral body
No spinous process
Atlanto occipital joint
With occipital condyles
Synovial joint
Thickened portions of atlas that support the skull
Superior facet and inf fac
Sup- occipital cond
Inf- axis
Ant longus colli and all
Dental fovea with dens of axis also called odontoid process
Post tubercle
Groove for ver art, c1 spinal nerve
Provides att to rectus capitis post musucl, nuchal lig
It is easily identifiable due to dens/odontoid process which extends sup from ant portion of vert
Has trasverse process, large bifid spinous process
Apex, ant art sur, post art surface
Apical lig att to apex
Art with trans lig
It ensures that the odointoid process maintains contact with atlas
Firmly attached on either side to the med surface of lateral masses
They connect the sides of odointoid process of axis to the tubercles on med side of occipital condyles
OPENING SEEN ON THE transverse process of all cer vert
Ver art and vein
Groove found on trans process of c3-c7
Spinal n passes laong the groove as it exits intervert foramina
Longus colli muscle atach
Rectus capiyis post minor attach
Cox its long spinous process protrudes from underthe skin and is visible to the naked eye
Flooe of post cranial fossa
Angle of mand
Ant post arch of atlas
Dens of axis
Harris ring is a ring like structure resulting from proj of lat masses of c2 on its body
Laminae of c2
Retropharyngeal
retrotracheal
Ant vert body line
Post vert body line
Spinal laminar line
Line across the spinous process
Too wide or narrow or uniform
Too wide or parallel
Too wide too narrow
dens occipital bone spinous process transverse band of t1 trachea first rib
Height of cervical bodies
Height of each joint space
Spinous process in alignment
Sub- head is not properly aligned with the spine. Occipital cond to latermass relation ruined
Distra- elevated increased distance bte occ cond and latermal masses
Occ cond floating
And the whole cer spine is pushed backwardsin relation to the head
Basion dense interval <9.5mm
For true jeff
Force hits the vertex of the head, go down through the occ condyles land on c1 and drive c1 to sides and disperse the fragments radially
Any tilt on the neck when the force is being applied
Motor vehicle crashes
falls
Typical hang amn
With frac of pars interarticularis
If vert body or transverse formen inv atypical
Vert body comp of c2
Not the same mech as judicial hanging
Bilateral Pars fracture
Anterior angulation
No significant translation
Disk and ligaments intact
Bilateral Pars fracture
Significant angulation
No significant translation
Disk and ligaments intact
Bilateral Pars fracture
Angulation and Translation
C2 c3 facet sub luxation or dislocation
No mvm of c2 ver body
Soft tissue swelling
Spinolaminar line c2 does not fall on the line
Harris ring is a ring like structure resulting from proj of lat masses of c2 on its body. Ring disrupted
Fat Body of c2
Thses could be the subtle radiolographic signs in hangman
these ligaments are present throughout the entire vertebral column.
Anterior and posterior longitudinal ligaments – long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs.
Ligamentum flavum – connects the laminae of adjacent vertebrae.
Interspinous ligament – connects the spinous processes of adjacent vertebrae.
Nuchal ligament – a continuation of the supraspinous ligament. It attaches to the tips of the spinous processes from C1-C7 and provides the proximal attachment for the rhomboids and trapezius.
Hit on the back
Hyoer flexion
Problem arising when you rip post long lig
Unstable
Facets parallel, v shaped or slide across one another
Little more force sub
continue dislocation
Gross dislocation
Last one in hyper flexion is flexion tear drop
Compression fractures the ant inf column of the vertebrae
Post lig dis and ant comp frac of vert body
Tear droop fragment
Spinal cord compression
Oblique frac through sup tip of dens
Rare
Stable when isolated
With a o dis
2- common. Transverse frac through base of the dens
Unstable prone to non union
3- through body of axis
Best prognosis
Normal variant
developmental anomaly of the odontoid process in which an ossification center that gives rise to the tip of the dens fails to fuse properly with the body of the axis.
Os- separation of odontoid process from body of axis
The ossiculum terminale appears as a secondary ossification center of the dens between 3-6 years and normally fuses by 12 years. Failure of fusion results in a persistent ossiculum terminale (also called Bergmann's ossicle or ossiculum terminale of Bergmann) and is considered a normal anatomical variant of the axis.
