Cervical spine fractures
Updates to Article Attributes
Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.
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. 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 worth bear in mind while interpreting paediatric studies. These include more horizontal orientation of the facet joints in children, underdeveloped uncal joints, mild physiological anterior wedging of the vertebral bodies, and incomplete ossification of odontoid process.
There are many types of cervical spine fracture, some of which are unstable; general indicators of instability include:
- more than one vertebral column involvement
- increased or reduced intervertebral disc space height
- increased interspinous distance
- facet joint widening
- vertebral compression greater than 25%
Some fractures are associated with blunt cerebrovascular injury (BCVI) such as high (C1 - C3-C3) fractures, those associated with subluxation and of course, those fractures involving the transverse foramen.
Mechanism
- hyperflexion: most common mechanism
- flexion teardrop fracture
- clay-shoveler fracture
-
facet dislocation
- bilateral facet dislocation (no rotation)
- unilateral facet dislocation (with rotation)
- anterior subluxation (hyperflexion sprain)
- hyperflexion fracture-dislocation
- hyperextension
- axial compression
- lateral flexion
- complex injuries
-</ul><p>Some fractures are associated with <a title="Blunt cerebrovascular injury" href="/articles/blunt-cerebrovascular-injury">blunt cerebrovascular injury</a> (BCVI) such as high (C1 - C3) fractures, those associated with subluxation and of course, those fractures involving the transverse foramen.</p><h5>Mechanism</h5><ul>- +</ul><p>Some fractures are associated with <a href="/articles/blunt-cerebrovascular-injury">blunt cerebrovascular injury</a> (BCVI) such as high (C1-C3) fractures, those associated with subluxation and of course, those fractures involving the transverse foramen.</p><h5>Mechanism</h5><ul>