Lower Cervical Spine Injuries

Question 1

These appear as a fracture of the anterior vertebral body margin. MOI is hyperflexion

Answer 1

Vertebral body compression fracture

Question 2

Intercalary bones, developmental platyspondyly, and normal vertebral body apophysis can all be examples of _________

Answer 2

Fracture fake outs

Question 3

The most common location for fractures in the cervical spine (accounts for 50% of all CS fx’s)

Answer 3

Posterior arch fractures

Question 4

Most common posterior arch fracture (most at C5-6)

Answer 4

Articular pillar fracture

Question 5

____ are most common in the lower cervical spine (clay shoveler fracture). They produce a “double spinous sign” on AP view. May be due to acute hyperflexion trauma or from repeated pull of upper traps and rhomboids.

Answer 5

Spinous process fractures

Question 6

Fracture of the anterior body margin secondary to a hyperextension force. George’s line intact, fragment is displaced anterior and inferior

Answer 6

Hyperextension teardrop fx

Question 7

Radiographs of this injury may show significant flexion at one level, with angular kyphosis and widening of the interspinous space. Can look similar to hyperextension fx. George’s line will be disrupted, however.

Answer 7

Hyperflexion teardrop fx

Question 8

MOI is hyperflexion. Facets at one level “ride up and over” facets at the level below. Facets can be completely anterior to or just “perched” on top of inferior facets. Immediate surgical referral

Answer 8

Bilateral facet dislocation

Question 9

MOI is hyperflexion on a rotated spine. Patient may present with torticollis. “Bow-tie” sign on LCN

Answer 9

Unilateral facet dislocation

Question 10

Abrupt change in the size of the lamina at the level of dislocation (LCN). Oblique and lateral image on same view (LCN). On AP view, abrupt deviation of spinous process

Answer 10

Unilateral facet dislocation

Question 11

Comminuted fx of the vertebral body. MOI is axial compression on a neutral spine. Risk of neurologic deficit from posteriorly projected fragments.

Answer 11

Burst fracture

Question 12

The MOI of articular pillar fractures is most often _____

Answer 12

Hyperextension

Question 13

In a ____ sprain, there is disruption of the ALL and anterior disc. Buckling of the ligamentum flavum may produce a ‘pinchers-like’ effect on the spinal cord.

Answer 13

Hyperextension