Cervical spine fractures

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 are worth bearing in mind while interpreting pediatric 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 the odontoid process.

There are many types of cervical spine fracture, some of which are unstable; general indicators of instability include:

Some fractures are associated with blunt cerebrovascular injury (BCVI) such as high (C1-C3) fractures, those associated with subluxation and of course, those fractures involving the transverse foramen.

Mechanism

The four major mechanisms are flexion, extension, rotational and shearing, each associated with certain fracture patterns 3,4

Fractures
Spinal trauma
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Article information

rID: 1089
Section: Gamuts
Synonyms or Alternate Spellings:
  • Cervical spine fracture
  • C spine fractures
  • C-spine fractures

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Cases and figures

  • Case 1: facet dislocation
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  • Midline
    Case 1: facet dislocation
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  • C-spine fracture ...
    Case 2: retropulsed fragment
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  • Case 3: Jefferson fracture
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  • Case 4: spinous process fractures
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  • Case 5: fracture dislocation C5-C6
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