Cervical Spine Theory

Question 1

What is paraplegia?

Answer 1

Paraplegia is paralysis affecting the lower half of the body, typically resulting from injury or disease of the spinal cord below the first thoracic vertebra (T1). It involves loss of sensory and/or motor function (depends on extent)

Question 2

Review the neck anatomy

Answer 2

The neck contains:
- Cervical vertebrae (C1–C7)
- Spinal cord and nerve roots
- Major blood vessels (carotid arteries, jugular veins)
- Trachea and esophagus
- Muscles (sternocleidomastoid, trapezius, scalene, etc.)
- Lymph nodes
- Thyroid and parathyroid glands

Question 3

Review of Cervical Vertebral Anatomy

Answer 3

C1 (Atlas): Supports the skull, allows nodding motion.
C2 (Axis): Has the odontoid process (dens) for head rotation.
C3–C6: Typical cervical vertebrae with small bodies, bifid spinous processes, and transverse foramina for vertebral arteries.
C7: Prominent spinous process (vertebra prominens).

Question 4

What are the key features of the cervical spine?

Answer 4

Vertebral body, pedicles, laminae, spinous process, transverse processes, vertebral foramen, intervertebral foramen.

Question 5

Understanding of Exit Foramina

Answer 5

Exit foramina (interv foramina) are openings between adjacent vertebrae where spinal nerves exit the spinal canal. In the cervical spine, these foramina are formed by the superior and inferior vertebral notches of adjacent vertebrae.

Question 6

Ring Theory

Answer 6

Ring theory (applied to the spine, especially the atlas and axis) states that a ring-like bone (such as C1) is unlikely to break in only one place. If a force causes a fracture, it often results in two breaks or a break and a dislocation, due to the ring structure distributing the force.

Question 7

A Clay Shoveller’s Fracture

Answer 7

A Clay Shoveller’s Fracture is an avulsion fracture of the spinous process, usually C6, C7, or T1. It is caused by a sudden, forceful muscle contraction (often from lifting or shoveling), or by direct trauma, pulling off the spinous process.

Question 8

How Do the Cervical Nerves Exit the Vertebrae?

Answer 8

Cervical nerves exit above their corresponding vertebrae, except for C8, which exits below C7 (since there are 7 vertebrae but 8 cervical nerves). For example, the C5 nerve exits between C4 and C5.

Question 9

Halo traction

Answer 9

Halo traction is a method of immobilizing the cervical spine using a metal ring (halo) fixed to the skull with pins and attached to a vest or traction device. It stabilizes cervical fractures or dislocations, especially in unstable injuries.

Question 10

Damage in Anterior longitudinal ligament

Answer 10

• Instability of the spine
• Increased risk of anterior vertebral dislocation
• Potential for spinal cord or nerve root injury
• Increased risk of further ligamentous or disc injury