cervical spine fractures

X-ray of the
cervical spine with a Hangman"s fracture. Left without, right with annotation. C2 (outlined in red) is moved forward with respect to C3 (outlined in blue).
Wikipedia • CC BY-SA 3.0
Cervical
Spine MRI of patient with SCI: C4 fracture and dislocation, spinal cord compression
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Praktisch
unverschobene, mehrfache Fraktur des Atlas im Sinne einer Jefferson-Fraktur bei einem 84 Jahre alten Mann nach Sturz auf den Kopf. Man erkennt in den beiden axialen Schichten der Computertomographie die Frakturlinien ventral und beidseits lateral. Keine Verlagerung des Dens.
Wikipedia • CC BY-SA 3.0
Teenager
ejected from the car in a motor vehicle accident with neck painCoronal (left) and sagittal (right) 2D reconstructions from a CT without contrast of the cervical spine show lucencies through the anterior and posterior aspects of the C7 vertebral body with loss of vertebral body height noted best on the sagittal image.The diagnosis was a compression fracture of C7.
pediatricimaging.org • CC-by-nc-sa 4.0
Teenager with
neck pain who dove into a shallow pond and felt a pop in their neckAxial (above) and coronal (left below) 2D reconstruction from CT without contrast of the cervical spine shows a lucency through the center of the C6 vertebral body. Sagittal 2D reconstruction (lower right) shows loss of height of the C6 vertebral body.The diagnosis was compression fracture of C6.
pediatricimaging.org • CC-by-nc-sa 4.0
Teenager in a
rollover MVA with neck painAxial CT (left) without contrast of the cervical spine with sagittal 2D reconstruction (right) shows a lucency through the left pedicle of the C6 vertebral body.The diagnosis was a fracture through the left pedicle of C6.
pediatricimaging.org • CC-by-nc-sa 4.0
School ager
hit by an all terrain vehicle with neck pain. Sagittal 2D reconstruction from CT without contrast of the cervical spine shows a rounded area of increased density inferior to the tip of the clivus and superiorly and posteriorly to the C2 vertebral body.The diagnosis was a retroclival hematoma with no associated cervical spine fracture.
pediatricimaging.org • CC-by-nc-sa 4.0
Cervical
spine fractures • Cervical vertebral body burst fracture with retropulsed fragment - Ganzer Fall bei Radiopaedia
Jones J, Cervical vertebral body burst fracture with retropulsed fragment. Case study, Radiopaedia.org (Accessed on 05 Jan 2023) https://doi.org/10.53347/rID-6150 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.

Epidemiology

Males are affected more commonly than females with the median age of injury being 56 years. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury .

Pathology

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. C2 (~30%) and C7 (~20%) are the most commonly fractured levels .

There are many types of cervical spine fracture, some of which are unstable; general indicators of instability include:

  • increased or reduced intervertebral disc space height
  • increased interspinous distance
  • facet joint widening
  • vertebral compression >25%
  • more than one vertebral column involvement
Associations

Associated injuries are present in ~67% of patients :

Pediatric

The fulcrum of movement is different in children than adults, C2/3 compared to C5/6, respectively; hence, in children, cervical fractures are more common in upper vertebrae. There are also other anatomical differences of the cervical spine between children and adults which are worth bearing in mind while interpreting pediatric studies. These include more horizontal orientation of the facet joints in children, underdeveloped uncovertebral joints, mild physiological anterior wedging of the vertebral bodies, and incomplete ossification of the odontoid process.

Mechanism

The four major mechanisms are flexion, extension, rotational and shearing, each associated with certain fracture patterns :

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Frakturen der Halswirbelsäule:
verbreiterter
prävertebraler Weichteilschatten
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Densfraktur
 
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Schipperfraktur
 
pediatricimaging.org • CC-by-nc-sa 4.0
Jefferson-Fraktur
 
Wikipedia • CC BY-SA 3.0
hangman
fracture
Wikipedia • CC BY-SA 3.0