1. Done by Alaa Reem Noura Alia Shaden
Spinal Injuries
Done by
Alaa Reem Noura Alia Shaden

2. Cervical Spine Injuries

3. Atlanto- Occipital Dislocation
Hyperextension and distraction mechanism
Down’s syndrome, RA more susceptible
Asymmetric lateral masses on odontoid view
Widened predens space
Treatment-
Often fatal
Highly unstable
If not fatal avoid traction

4. Atlas Fractures Neural Arch Fracture of C1 Most common fracture of C1
Hyperextension injury
Not associated with neurologic deficit
May be confused with congenital abnormality

5. Jefferson fracture Burst fracture of atlas (C1)
Usually bilateral breaks in ant/ post arches
Vertical compression/ axial load injury
Widened lateral masses of C1 on open-mouth odontoid view
Widened predens space
Neuro deficits uncommon

6. Axis Fractures Odontoid fracture
Incidence: 6% of cervical spine fractures
Associated with atlas fractures in 8%
Hyperextension
Often forward subluxation of C1 on C2
Odontoid fracture
Type I
Type II
Type III

7. Hangman’s Fracture Most common fracture of C2
Bilateral fracture of pedicles of axis (C2)
Anterior slip of C2 on C3
Mechanism: Sudden deceleration with hyperextension
May or may not have anterior subluxation
Unstable

8. Compression Fracture Flexion injury
Anterior wedging of 3mm or more suggests fracture
Usually involves superior endplate of vertebral body

9. Unilateral facet dislocation
Mechanism: flexion, combined flexion/ rotation
Anterior dislocation of one vertebral body by % on lateral view
Only 30% associated with neurologic defect

10. Bilateral Facet Dislocation
Mechanism: flexion, combined flexion/ rotation
Anterior dislocation of one vertebral body by 50% on lateral view
Unstable
Neurologic deficits common
Seen in up to 85%

11. Lumbar spine fracture

12. Lumbar spine fracture
The lumbar vertebrae are the 5 largest and strongest of all vertebrae in the spine & it comprises the lower back.
Causes
Traumatic fractures 
Non-traumatic fractures

13. Traumatic fractures caused by high-energy trauma, such as: Car crash
Fall from height
Sports accident
Gunshot wound

14. Non-traumatic fractures
caused by a disease, such as:
Osteoporosis
Multiple myeloma (bone Tumour)
Bone Metastasis

15. Fractures types 1-Flexion Wedge Compression fracture A burst fracture
2- Extension
Chance fracture.
3- Rotation
Transverse process fracture
4- Fracture-dislocation
Spondylolisthesis

16. Wedge Compression fracture
The vertebral body is compressed.
the front of the vertebra is breaks.
the back part does not effected.
Most Common fracture & usually it is stable & painful #
Cause by: an external force is applied to the spine, such as a fall or carrying of a sudden heavy weight
Rarely associated with neurologic problems.

17. Burst fracture
Is axial compression fracture in which the entire spinal vertebra breaks.
The vertebra is break on both the front and back sides.
Caused by a fall from a height and landing on the feet.

18. Chance fracture
It is acute hyperflexion of the spine which distraction the  posterior and impaction of the anterior vertebra.
L1 and L2 most commonly
Common symptom is a back pain

19. Transverse process fracture
Multiple avulsion fractures.
Results from severe hyperextension and lateral flexion
The most common fractures are L2 and L3

20. Spondylolisthesis
The vertebra (usually L5) is slips forward or backward compared to the next vertebra(usually the sacrum).
it is more common in girls than boys.

21. Symptoms:
Low back pain
Feeling of “hamstring tightness”
Pain radiating down the legs
Difficulty with upright posture and gait

23. Sacral Fracture

24. Sacral Fracture What is a sacral fracture?
A sacral fracture is a break in your sacrum. Which is a triangle-shaped (three sided) bone made up of five fused (joined) vertebrae. A sacral fracture more commonly occurs in older adults because they have weaker bones, Young, active people, may also get sacral fractures.

25. What causes a sacral fracture?
Sacral fractures are usually caused by an injury to the sacrum. These injuries can be caused by any of the following:
1-Activities which are too hard for the sacrum to withstand.
2-Car accidents.
3-Fall from height.
4-Having diseases that affect the bone, such as osteoporosis, or bone cancer.

26. Types of sacral fractures :
Sacral Stress Fractures
Sacral Insufficiency Fractures
Traumatic Sacral Fractures

27. Sacral Stress Fractures :
a sacral stress fracture occurs in young, active patients. These injuries are closely related to sacral insufficiency fractures described below, but the bone is usually not osteoporotic. Rather than the bone not being healthy enough, the activities simply are too much for the sacrum to resist, and a stress fracture results.

28. Sacral Insufficiency Fractures
Sacral insufficiency fractures usually are parallel to the spine. They are most often in the ala, just beside the sacroiliac joint, and sometimes there is also a transverse fracture. It is occur in elderly patients with osteoporosis. These fractures may be the result of a fall or may be the result of no particular injury.

29. Sacral Insufficiency Fractures :
Sacral insufficiency fractures may not be seen on regular x-rays, but usually show up on MRI or CT scans of the pelvis.

30. Traumatic Sacral Fractures :
Traumatic fractures of the sacrum can occur with pelvic fractures. These injuries commonly occur in car accidents and severe falls.

31. Coccyx (Tailbone)
Coccyx fracture
Coccyx Dislocation

32. Coccyx fracture
The coccyx is the final vertebral segments of the spinal column and is commonly called the tailbone. Tailbone fracture is a fracture to the small bone at the lower tip of the spine. Actual fractures of the tailbone (coccyx) are not common.
Causes :
A fall onto the tailbone in the seated position, usually against a hard surface, is the most common cause of coccyx injuries.
The coccyx can be injured or fractured during childbirth.

33. Coccyx dislocation
The dislocation of the coccyx occurs when there is a separation of the coccyx from the sacrum.
The coccyx may displacement Backwards or forward.

34. Causes :
In order for the coccyx to be displaced, it must be subjected to a significant force. The two most frequent causes are:
1-Falling on the tailbone, where the intensity of the fall displaces the coccyx.
2-Labor, in which the fetus displaces the coccyx, usually backwards, during its passage through the birth canal. This can occur when the size of the baby and the size of the mother's pelvis are slightly out of proportion

35. References

36. Thanx 