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33 Cards in this Set
- Front
- Back
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Most common level of C-spine FLEXION/axial load injury? |
C5 -compression fracture due to hyperFLEXION or axial load (diving)
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What type of injury may happen in the cervical spine with flexion/rotation? Most common level?
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Unilateral facet joint dislocation
<50% ANTERIOR displacement of vertebral body on xray C5-C6 most common *more likely to be INCOMPLETE than bilateral dislocation *flexion-rotation injuries in THORACOLUMBAR region are more likely to be COMPLETE though. |
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A unilateral facet joint dislocation in the c-spine is considered unstable if what?
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POSTERIOR longitudinal ligament is disrupted
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What type of injury of the c-spine will you see >50% anterior displacement of the vertebral body in?
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BILATERAL facet joint dislocation (unilateral results in <50% dislocation)
- again unstable if PLL is disrupted *more likely to be complete than unilateral dislocation. |
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What is the most common level of injury for a cervical bilateral facet joint dislocation?
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C5-C6, same as for a unilateral. C5 is most common for compression fracture.
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What type of cervical spine injury is usually due to an ACCELERATION-DECELERATION?
Most common level? |
HyperEXTENSION injury
C4-C5 most common level |
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Hyperextension of the C-spine in the ELDERLY will most likely result in what kind of injury?
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CENTRAL CORD syndrome
- incomplete injury - Upper extremities weaker than lowers |
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Two most common causes of NON-TRAUMATIC SCI?
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1. Stenosis
2. Tumors |
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Which sex is more likely to develop TRANSVERSE MYELITIS?
- Peak age? |
FEMALES (4:1)
- 20's-40's |
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Epidural abscesses are most commonly seen in those with what two health issues?
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1. Diabetes
2. Immunocompromised |
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What is the prognosis like for RADIATION MYELOPATHY?
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Significant recovery is poor
- Incidence correlates with total radiation dose, dose fraction, & length of spinal cord irradiated |
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Where are the majority of spinal cord tumors located -what layer of neurologic tissue?
What level? Primary or metastatic? |
EXTRAdural
Thoracic METASTATIC (95%) |
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3 most common primary sources of spinal cord tumors
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1. Lung
2. Breast 3. Prostate |
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What are the two most common TYPES of spinal cord tumors?
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1. Ependymoma
2. Astrocytoma |
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If you are over the age of 50 is it statistically better for you to have a traumatic or non-traumatic SCI?
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NON-traumatic
- lower incidence of complications - more likely to be incomplete - shorter inpt rehab length of stay |
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What is the MOST restrictive cervical orthosis available?
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HALO
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What is more restrictive, a SOMI or a 4 poster? List other cervical orthoses in order of restrictiveness.
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MOST restrictive
1. Halo 2. Minerva brace 3. 4 poster 5. SOMI 6. Philadelphia collar 7. Soft collar LEAST restrictive |
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What does SOMI stand for?
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Sternal-Occipital-Mandibular Immobilizer
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More like to be complete or incomplete injury?
Flexion-Rotation injury in the THORACOLUMBAR area? |
COMPLETE
*incomplete if in the cervical area (unilateral facet joint dislocation) |
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More like to be complete or incomplete injury?
Flexion-Rotation injury in the CERVICAL area? |
INCOMPLETE (unilateral facet joint dislocation)
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What is a JEFFERSON fracture?
How do you treat it? |
BURST fx of C1 (atlas) ring - d/t axial loading, usually has NO neurological findings
- stable = HALO - unstable = surgery |
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What is a HANGMAN fracture?
How do you treat it? |
C2 (axis) BURST fracture
Abrupt DECELERATION injury (head hitting windshield) - usually stable with minimal neuro findings = halo - unstable = surgery |
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What is a TYPE I dens fx?
How do you treat it? |
fx thru the TIP of the dens
- no Tx required |
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What is a TYPE II dens fx?
How do you treat it? |
fx at the BASE of the dens
- HALO vest or possibly surgery *most common type of dens fx |
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Which type of DENS fx is most common?
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Type II
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What is a TYPE III dens fx?
How do you treat it? |
fx of the BASE of the dens that EXTENDS into the vertebral body of C2 proper
- HALO vest or possibly surgery |
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What is a CHANCE fx?
What levels does it usually occur at? |
Transverse fx that travels POSTERIOR to ANTERIOR
- thru spinous process, pedicles, and into vertebral body - T12, L1, L2 |
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What causes CHANCE fxs?
Are they typically unstable or stable? |
HYPERFLEXION of thorax
- acute fall/crush - past: lap belts - typically stable and not associated with neuro compromise unless significant translation occurs |
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What is a DOWAGER hump?
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Deformity caused by thoracic kyphosis
- may be associated with thoracic vertebral body compression fxs |
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Name 3 things that predispose children to SCIWORA
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1. horizontal orientation of CERVICAL facet joints
2. large HEAD to neck size ratio 3. increased elasticity of the spine |
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What two age populations do you see SCIWORA in?
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Children & older adults
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What is the typical mechanism of injury for SCIWORA in older adults?
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fall + HYPEREXTENSION injury = central cord syndrome
- may cause LIGAMENTUM FLAVUM to bulge anteriorly into spinal canal |
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What precautions should be taken for an older patient suspected of having SCIWORA?
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- Empiric 24 hr cervical collar
- repeat films at resolution of cervical spasm - caution if performing flex/ex films - only after static films cleared by radiologist and no pain/neuro symptoms exist |
