Sub-Axial Cervical Spine Instability Following Unilateral Facet Injury: A Biomechanical Analysis

2010 ◽  
Author(s):  
Stewart D. McLachlin ◽  
Parham Rasoulinejad ◽  
Kevin R. Gurr ◽  
Stewart I. Bailey ◽  
Chris S. Bailey ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Injury Pattern ◽  
Biomechanical Analysis ◽  
Spine Injury ◽  
Spinal Stability ◽  
Considerable Variability ◽  
Cervical Spine Instability ◽  
Choice Of Treatment ◽  
Posterior Ligament ◽  
Type Of Injury

Unilateral facet injuries are relatively common in the sub-axial cervical spine. Facet fractures, capsular disruptions, and posterior ligament tears can all contribute to this type of injury resulting in a range of instability spanning undisplaced fractures to complete unilateral dislocations [1]. For a particular injury pattern, considerable variability exists in the choice of treatment, and the modality selected is frequently based on surgeon preference [2]. This is due, in part, to a lack of biomechanical studies focused on increasing the understanding of changes in spinal stability that occur following cervical spine injury.

scholarly journals The state of the sagittal balance of the injured cervical spine depending on the nature of the damage to the subaxial level

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 48-57
Author(s):  
O.S. Nekhlopochyn ◽  
V.V. Verbov
Keyword(s):  
Cervical Spine ◽  
Sagittal Balance ◽  
Traumatic Injury ◽  
The State ◽  
Sagittal Profile ◽  
Spine Injury ◽  
Cervical Lordosis ◽  
Subaxial Cervical Spine ◽  
Wide Range ◽  
Type Of Injury

Background. Three main interrelated principles form the basis for modern surgery of traumatic cervical spine injuries, namely decompression, reconstruction and stabilization. Restoration of the sagittal profile is one of the basic tasks of the reconstructive stage. Currently, there are no clear recommendations for surgical management in traumatic injuries depending on the degree of deformation, and the state of sagittal balance of the injured cervical spine in the preoperative period has practically not been studied. The purpose of the work is to study the state of the sagittal profile and the degree of segmental deformation of the cervical spine following traumatic injury at the subaxial level, to determine the relationship between them and the type of injury. Materials and methods. We performed a retrospective analysis of X-ray data from 140 patients with subaxial cervical spine traumatic injury who were hospitalized at the Department of Spinal Cord Pathology of the Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine in the period from 2008 to 2018. We calculated indicators of segmental kyphosis and general cervical lordosis and determined the type of damage according to AO Spine Subaxial Cervical Spine Injury Classification System. Results. We found that the type of the damage affects the degree of segmental deformation (p < 0.001). Type A1, A2 and C injuries show the maximum kyphotic angulation: 13.51° (8.18; 20.07), 21.8° (20.12; 22.96) and 20.01° (17.52; 21.99), respectively. Injuries of type A2 and C statistically significantly differ from other types of lesions. We registered maximum values of deviations from the normal sagittal circuit in patients with injuries types A2 and C: ‒26.77° (‒32.78; ‒20.91) and ‒26.70° (‒36.30; ‒16.77), respectively. The parameters of segmental kyphosis and general cervical lordosis reveal high interdependence (r2 = 0.766, p < 0.001). We found maximum correlation in type A3, A4 and B3 injuries: ‒0.93, ‒0.91 and ‒0.97, respectively (p < 0.001). And types A1 and A2 injuries demonstrated statistically insignificant relationship (p > 0.05). Conclusions. The results show that traumatic injury of the subaxial cervical spine is characterized by a wide range of kyphotic segmental angulation values, which is largely determined by the type of injury. General cervical lordosis tends to flatten in most cases, but the degree of physiological curvature loss correlates with local deformation to some extent.

Condition of Vertebral Arteries in Experimental Modelling of Low Cervical Vertebrae Dislocation

2004 ◽  
Vol 11 (1) ◽  
pp. 14-19 ◽  
Author(s):  
S T Vetrile ◽  
S V Yundin ◽  
A I Krupatkin ◽  
S V Kolesov ◽  
E V Ogarev ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Sagittal Plane ◽  
Frozen Section ◽  
Cervical Vertebrae ◽  
Spine Injury ◽  
Experimental Modelling ◽  
Vertebral Arteries ◽  
Vascular Factor ◽  
Choice Of Treatment ◽  
External Fixation Device

Condition of vertebral arteries in experimental modeling of cervical vertebrae dislocations at C3-C6 level was studied on 20 section-blocks of cervical spine. Vertebral arteries were contrasted and cervical block was fixed using external fixation device. Various types of dislocation and subluxation under X-ray control were produced. Thus, it was possible to observe dynamic picture of vertebral arteries deformation in traumatic cervical vertebrae dislocation. To confirm the results of angiography the cut up of frozen section-blocks in sagittal plane and in vertebral arteries projection as well as visual control (photography of vertebrae dislocation steps) were performed. Results of experimental study allowed to detect peculiarities of vertebral arteries deformations in cervical vertebrae dislocation and to determine the correlation between the degree of vertebrae dislocation and severity of extracranial vertebral artery deformation. It enables to predict the degree of hemodynamic disorders in the system of vertebral arteries, to determine the role of vascular factor in cervical spine injury and to use the differentional approach to the choice of treatment tactics using routine roentgenography.

scholarly journals Anterior cervical corpectomy and fusion in a 7-year-old boy: a case report

2019 ◽  
Vol 28 (2) ◽  
pp. 183-7
Author(s):  
Mohamad Saekhu ◽  
Samsul Ashari ◽  
David Tandian ◽  
Setyo Widi Nugroho
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Cord Compression ◽  
Spine Injury ◽  
Research Report ◽  
Cervical Spine Instability ◽  
Cervical Corpectomy ◽  
Primary Surgery ◽  
Cervical Plate ◽  
Anterior Cervical Corpectomy

Bicycle mishap, a common and ordinary event occurring in children, can have devastating consequences associated with cervical spine injury. Furthermore, either diagnosis or surgical management of cervical spine injury in children is a challenging issue. This research report a challenging case of an anterior cervical corpectomy and fusion with plating in a 7-year-old boy due to cervical spine instability with spinal cord compression after a bicycle mishap. After 20 months of the primary surgery, the titanium-based cervical plate was removed by a second surgery to allow the growth of the cervical spine.

The cervical spine injury pattern without and with helmet in motorcycle accident

2006 ◽  
Vol 39 ◽  
pp. S536
Author(s):  
S.-W. Yang ◽  
Y.-L. Cheng ◽  
K.H. Yang ◽  
S.-J. Hsieh
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Injury Pattern ◽  
Spine Injury ◽  
Motorcycle Accident

Traumatic Cervical Spine Injury Pattern– A Snapshot

2012 ◽  
Vol 23 (3) ◽  
pp. 111-116
Author(s):  
M Joshi ◽  
Mahima Agrawal
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Spinal Injury ◽  
Tertiary Care ◽  
Injury Pattern ◽  
Spine Injury ◽  
Rehabilitation Centre ◽  
Cross Sectional

Abstract Study design and subjects Cross-sectional descriptive study of pattern of cervical spine injury at a tertiary care rehabilitation centre in Rajasthan. Objectives To observe the socio demographic profile and injury pattern in cervical spinal cordinjury. Methods One hundred and forty-one clients of traumatic cervical spine injury (CSI) were admitted from 1st December 2010 to 15th October 2011 at the Department of Physical Medicine and Rehabilitation, S.M.S. Medical College and Hospital, Jaipur. Detailed clinical, neurological evaluation as per American Spinal Injury Association Classification (ASIA) and radiological assessment were done along with identification of mechanism of injury, mode of evacuation and presence of associated injuries. Data analysis was done in October 2011 and results were compiled and analysed. Results Mean age in our sample was 35.87 ± 14.38 years that comprised 11 females (7.8%) and 130 males (92.2%) of whom 78 (55.3%) fell in the age group of 25 to 55 years. Majority 64 (45.4%) were illiterate, 80 (56.8%) being farmers and labourers. Greater fraction had road traffic accidents i.e., 66 (46.81%) and fall from height 56 (39.72%) as the mechanism of trauma. Only 69 (49.8%) could arrange an ambulance for transport. Majority of the injured i.e., 84 (59.57%) presented with neurologically complete picture as per ASIA classification and the most common involvement being of 5th and 6th cervical segments i.e., 103 (73.15%). Conclusion This study evaluated the demographic variables of cervical spine injury for better understanding of impact that it has and further for better allocation of our health resources, distribution and planning

Airway management: Uncleared cervical spine injury

2005 ◽  
Vol 2 (2) ◽  
pp. 99-101 ◽  
Author(s):  
TVSP Murthy ◽  
Parmeet Bhatia ◽  
RL Gogna ◽  
T Prabhakar
Keyword(s):  
Cervical Spine ◽  
Airway Management ◽  
Cervical Spine Injury ◽  
Spine Injury

Stabilization for sub axial cervical spine injury

2004 ◽  
Vol 1 (1) ◽  
pp. 43-47
Author(s):  
PK Sahoo ◽  
Prakash Singh ◽  
HS Bhatoe
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Spine Injury

Acute Traumatic Cervical Facet Fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 5
Author(s):  
Shankar Gopinat
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Early Surgery ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Spinal Stability ◽  
Fracture Patterns ◽  
Spine Ct ◽  
Cervical Facet

Acute cervical facet fractures are increasingly being detected due to the use of cervical spine CT imaging in the initial assessment of trauma patients. For displaced cervical facet fractures with dislocations and subluxations, early surgery can decompress the spinal cord and stabilize the spine. For patients with non-displaced cervical facet fractures, the challenge in managing these patients is the determination of spinal stability. Although many of the patients with non-displaced cervical facet fractures can be managed with a cervical collar, the imaging needs to be analyzed carefully since certain fracture patterns may be better managed with early surgical stabilization.

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