1. SPINE TRAUMATOLOGY M. Krbec, M. Repko, M. Rouchal,
L. Ryba, R. Chaloupka
Ortopaedic Univ. Dept.
FN Brno-Bohunice

2. SPINE cervical C thoracic T lumbar L sacrum coccyx body support
spinal cord / dura protection

3. Anatomy of vertebra Vertebral body Pedicles Arch Articular processes
- superior
- inferior
Transverse processes
Spinous process

5. Now 2-column theory(Magerl)
Denis 3-column theory
Now 2-column theory(Magerl)

6. C1
C1 = atlas
Arches + articular processes

7. C2
axis
Body
Dens
Articular processes

8. Discus intervertebralis discus intervertebralis

9. EXAMINATION Clinical examination X-ray Neurological CT MRI
Case history

10. TYPES OF INJURY Forces, directions
Axial pressure
Bending pressure
Rotation
Combination

11. MECHANISM OF INJURY
Falls
Traffic accidents
Sport

12. Hematomyelia

13. Denis‘ classification 3 three-column concept
A compressive
B burst
C flection-distraction
D rotational forces
(shear, translation)

14. AO classification Magerl et al. 2-column compression distraction
A,B with rotation

15. Frankel classification
A complete loss of motor end sensory functions
B no motor preservation, sensory function only
C useless motor function preserved
D motor function less than normal
E normal neurological status

16. THERAPY conservative surgical orthosis, plaster cast bed rest
posterior surgery
anterior surgery
combined

17. FIRST AID CERVICAL SPINE FIXATION
TO AVOID MOVEMENT WITH THORACIC AND LUMBAR SPINE DURING MANIPULATION
SPINAL DEPARTMENT

18. SURGICAL INDICATION NEUROLOGICAL LESION SPINE INSTABILITY
OPERATION UP TO
6 HOURS !
SPINE INSTABILITY

19. CONSERVATIVE THERAPY
Bed rest
Collars- soft
-Philladelphia

20. CONSERVATIVE THERAPY T SPINE T8 - 12 Jewett orthosis LS SPINE
lumbar belt L4 - S1

21. HALO - TRACTION

22. CONSERVATIVE TREATMENT -plaster casts
C spine
halo-cast, halo-vest
Minerva cast / vest

23. CONSERVATIVE TREATMENT -plaster cast

26. SURGICAL THERAPY DECOMPRESSION OF NEUROGICAL STRUCTURES
REDUCTION OF DEFORMITY
HEALING WITH SOLID FUSION

27. SURGICAL THERAPY acute period
C spine
anterior surgery
T, L spine
posterior surgery

28. BASIC PRINCIPLES OF SURGICAL THERAPY
reduction
lordotisation
stabilisation

29. POSTERIOR APPROACH TO THE T-L SPINE
Pedicle screws
Bones
Rods
Cross-links

30. intersomatic
fusion
spongioplasty

31. POSTERIOR STABILISATION OF THE SPINE CT scan – TRANSPEDICULAR SCREWS

34. T-L SPINE – ANTERIOR SURGICAL APPROACH
replacing the vertebral body
stabilisation

37. posterior instrumentation
Harms cage
anterior instrumentation

38. Synex
extended impl.

42. C1,2 – SPINE INJURIES Rare, big violence on OC a C-SPINE
Occipital fracture
C-1 arch fracture
Odontoid C-2 fracture
Body C-2 fracture
CONSERVATIVE THERAPY

43. DENS FRACTURE

44. DENS FRACTURE

45. HANGMAN‘S C-2 FRACTURE TRAUMATIC SPONDYLOLISTHESIS OF AXIS

47. Anterior fusion and plate

48. CERVICAL SPINE INJURIES
Comminuted body fractures (burst)
Injuries of discs and ligaments
disc and ligamentous disruption
Combined
- teardrop, fracture dislocations

49. C- SPINE anterior surgery body replacement disc replacement
stabilisation

50. CERVICAL PLATES
SYNTHES
CASPAR

51. POSTERIOR SURGERY
Hartshill

52. STABILISATION O-C ARTICULATION
Synthes
Star Lock
CerviFix ……..

53. HOOK PLATES
disc and ligamentous disruption

54. POSTOPERATIVE AFTERTREATMENT
collar
Jewett orthosis, lumbar belt
plaster cast

55. Thank you for attention