颈椎骨折英文 ppt课件

C1-C2
Predental space
(distance between posterior aspect of anterior arch of C1 and anterior aspect of odontoid process )
should be< 3mm In adult and less <5mm in children Or less ring sign of C2
Transverse Ligament
AtlantoAxial Anatomy
Vertebral Artery
APPROACH TO C-SPINE INJURIES
▪Following trauma or complaint of neck pain Obtain lateral AP, and odontoid views The lateral view is only adequate if T1 can be visualized
Internal:
○ Tectorial membrane ○ Cruciate ligament – including transverse ligament ○ Alar and apical ligaments
External
○ Anterior and posterior atlanto-occipital membranes ○ Anterior and posterior atlanto-axial membranes ○ Articular capsules and ligamentum nuchae
Facet joints should be parallel
Interspinous distance should decrease from C3 to C7 Transverse process of C7 points downward and
T1 UPWARDS
FACET JOINT
○ Vertebral artery groove
C2 Anatomy
Dens
Embriological C1 body Base poorly vascularized Osteoporotic
Flat C1-2 joints
Vertebral artery foramena
Inferomedial to superolateral
10m m
5mm
22mm
AP View
The height of the cervical vertebral bodies should be approximately equal
INTERVERTE BRAL DISC
SPACES
▪Prevertebral Soft Tissue
Nasopharyngeal space (C1) - 10 mm (adult)
Retropharyngeal spaceC 2-C4 ( between posterior pharyngeal wall and anterior border of vertebrae).
Anatomy – The Ligaments
Allow for the wide ROM of upper C-spine while maintaining stability
Classified according to location with respect to vertebral canal
Unique osteological characteristics
C1 - Atlas
No body 2 articular pillars
Flat articular surface Vertebral artery
foramen
2 arches
Anterior Posterior
AtlantoAxial Anatomy
Tectorial Membrane
AtlantoAxial Anatomy
Tranverse Ligament C1-C2 joint
Alar Ligament
occiput
C1 C2
AtlantoAxial Anatomy
Facet for Occipital Condyle
C3-C7
Anterior spinal, posterior spinal and spinolaminar lines: should be smooth lines
Disc Spaces should be approximately same
anterior narrowing = flexion injury. Widening = extension injury
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Cervical Views
Odontoid AP
Swimmer’s View
LATERAL VIEW
▪1. Anterior vertebral line (anterior margin of vertebral bodies) ▪2. Posterior vertebral line (posterior margin of vertebral bodies) ▪3.Articular pillar (where superior and inferior articular processes of cervical vertebrae have fused
Cervical Spine fractures…
Cervical Anatomy
Biomechanically Specialized
Support of “large” Cranial mass Large range of motion
○ Flexion/extension ○ Axial rotation
▪If there is any doubt of fracture or prevertebral swelling , obtain oblique views and consider CT ▪All patients with sign/symptoms of cord injury require MRI