Cervical Spine fractures muhamma

Cervical Spine fractures…
Classification of Hangman' s fractures 

Type I (65%)
hair-line fracture
C2-3 disc normal
Type II (28%)
displaced C2
disrupted C2-3 disc
ligamentous rupture with
instability
C3 anterosuperior compression
fracture
Type III (7%)
displaced C2
C2-3 Bilateral interfacet dislocation
Severe instability
 The most common scenario would be
frontal motor vehicle(hitting dash board)
Hanging
falls,
diving injuries
contact sports.
Neurological involvement is rare

Ap view show ghost sign with 2 spinous processes ???
TYPE 1 HANGMAN FRACTURE
There is a hair-line fracture and there is no displacement.
C23 NORMAL
HANGMAN FRACTURE TYPE 3
Anterior dislocation of the C2 vertebral body



BILATRAL C2 pars interarticularis fractures.
Prevertebral soft tissue swelling
The CT-images confirm the fracture-lines of the hangman's fracture.
They run through the pars interarticularis resulting in a traumatic spondylolysis.
In this case there was no neurologic deficit, because the spinal canal is widened at the level of the fracture.

Extention tear drop fracture
AVULSION FRACTURE of anterio inferior content
of the axis resulting from hyperextention
This injury is
stable in flexion
but highly unstable in extension.

common in diving accidents
It also may be associated with the central cord
syndrome .
Hangman's Fracture C-2
Fx through the pars interarticularis of C2 secondary to hyperextension

Best seen on lateral view
Hyperextention injury
Stable fracture ?


Wedge shape vertebra
Antersuperior body fracture
Fracture of the body of c5 with a small fragment anteriorly
Fracture of the spinous process of C4
Acute angulation at the level of C5C6 with displacement of C5 in posterior direction


Signs:
Prevertebral swelling associated with anterior longitudinal ligament tear.

Teardrop fragment from anterior vertebral body avulsion fracture.

Posterior vertebral body subluxation into the spinal canal.

Spinal cord compression from vertebral body displacement.

Fracture of the spinous process.
Flexion Teardrop Fracture C5-6
fracture is the result of a combination
of flexion and compression ,most commonly at C5-6
The teardrop fragment comes from the
anteroinferior aspect of the vertebral body. The
larger posterior part of the vertebral body
is displaced backward into the spinal canal.

Best seen on lateral view
It is an completely unstable fracture associated with
complete disruption of ligaments and anterior cord
syndrome and quadriplegia
70% of patients have neurologic deficit.
common in MOTOR VECHICLE ACCIDENT

Types of Injuries
Wedge fracture
Compression fracture resulting from flexion.
Flexion compression injury
Best seen on lateral view
Stable
Common in
Elderly patients with osteoporosis or osteogenesis imperfecta


The CT confirms the displaced anteroinferior bony fragment. 
This fragment is a true avulsion, in contrast to the flexion teardrop fracture in which the fragment is produced by compression of the anterior vertebral aspect due to hyperflexion.

Jefferson Fracture C-1









Best seen on odontoid view
Unstable fracture
Fracture due to AXIAL LOADING
frequently associated with
diving into shallow water(axial blow to the vertex of the head )

impact against the roof of a vehicle
fall from playground equipments


Fracture is caused by a compressive downward force that is transmitted evenly through the occipital condyles to the superior articular surfaces of the lateral masses of C1. 
This process displaces the masses laterally and causes fractures of the anterior and posterior arches, along with possible disruption of the transverse ligament.

SIGNS ON XRAY: Displacement of the lateral masses of vertebrae C1 beyond the margins of the body of vertebra C2.