Presentation
A 14-year-old girl presented with severe neck pain following a fall from a bunk bed. MRI investigation showed signs of axial loading and hyper-flexion yielding a teardrop fracture at the body of the C5 vertebra. [casereports.bmj.com]
A 32-year-old man presented for an evaluation of his cervical spine to determine whether he had the same congenital anomaly that had been diagnosed in his three-year-old daughter; his daughter required surgery. [aafp.org]
The Case: An 83-year-old man presented with symptoms of an acute cord syndrome following an altercation. [healio.com]
Presentation on theme: "Cervical Spine Trauma. [slideplayer.com]
Compression fractures may present as anterior wedging of the vertebral body or teardrop fractures of the antero-inferior portion of the body (compression in flexion). [trauma.org]
Entire Body System
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Soft Tissue Swelling
Lateral cervical spine: Flexion teardrop fracture of C5 vertebral body with associated soft tissue swelling. CT spine: Oblique fracture through the anterior inferior margin of the C5 vertebral body with retrolisthesis of C5 over C6. [www2.med.wayne.edu]
tissue swelling As a rule of thumb, the soft tissue anterior to C3 should be less than 1/2 of the AP diameter of C3 and the soft tissue anterior to C6 should be less than 2/3 of the AP diameter of C6 Differential Diagnosis Flexion teardrop fracture also [learningradiology.com]
"The Significance Of Prevertebral Soft Tissue Swelling In Extension Teardrop Fracture Of The Cervical Spine".... [dx.doi.org]
Additional findings may include a sagittal fracture through the vertebral body with kyphotic deformity, facet disruption, anterior cervical soft tissue swelling, ALL disruption, and a flattened disc below the fractured vertebral body. [prod.wiki.cns.org]
Soft tissue swelling anterior to the arch of C1 will suggest the presence of a fracture at this level. The Atlanto-Dens Interval (ADI) in adults should be 3mm (in flexion). [trauma.org]
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Camping
Van Camp Lippincott Williams & Wilkins, 1998 - 717 من الصفحات This manual is the perfect pocket reference for all health care professionals who care for athletes, including sports medicine specialists, orthopaedic surgeons, family practitioners, physical [books.google.com]
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Soft Tissue Mass
In adults, widening of the prevertebral soft tissue mass in the upper neck is an important warning sign of major underlying trauma. Various Reference lines can help in identifying alteration in normal upper cervical spine outline. [boneandspine.com]
Respiratoric
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Pharyngitis
The soft tissue shadow is created by the pharyngeal and prevertebral tissues, with the posterior larynx and oesophagus thickening the shadow below C4. [trauma.org]
[…] more than 3.5 mm segmental disc space widening on lat XR facet jt widening malalignment of spinous processes of ant view Rotation of the facets on lat XR at tilt of vertebral body on ant XR XR findings suggestive of unstable injuries Increased retro pharyngeal [flinders.edu.au]
Atlantoaxial rotary subluxation in children, an atraumatic injury, which typically occurs following upper pharyngeal infections, is a different entity. [appliedradiology.com]
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Pneumonia
[…] nonoperative treatment - continued traction supine until healing in general the greater the neuro deficit the greater the effort to move the pt into the upright posture early as they tolerate recumbency poorly complications include: resp- atelactasis, pneumonia [flinders.edu.au]
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Aspiration
Illustrated appendices cover injections and aspiration of joints, taping techniques, and selected musculoskeletal examination techniques. Paperback edition available only in selected countries. [books.google.com]
Neurologic
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Confusion
The flexion teardrop fracture is a specific entity that should not be confused with other types of injury with a teardrop fragment. [ncbi.nlm.nih.gov]
[…] at the injured level.[2] A flexion teardrop fracture is usually associated with a spinal cord injury, often a result of displacement of the posterior portion of the vertebral body into the spinal canal.[3] The flexion teardrop fracture should not be confused [en.wikipedia.org]
They should not be confused with extension teardrop fractures, which tend to occur higher within the cervical spine and are considered less severe injuries 1. [radiopaedia.org]
On the left images of an unrestrained passenger, who was ejected from a vehicle and found confused and combative at the scene. He was intubated and taken to a hospital, where he was found to be quadriplegic. [radiologyassistant.nl]
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Spinal Cord Syndrome
The displacement of the posterior vertebral fragment into the spinal canal typically produces an anterior spinal cord syndrome characterised by quadriparesis and loss of temperature and pain sensation. There are no threads for this page. [wikiradiography.net]
Spinal cord syndromes (2): Central cord syndrome Most common incomplete cord syndrome. Frequently found in elderly with underlying spondylosis or younger people with severe extension injury (figure). [radiologyassistant.nl]
Treatment
Author information 1 Department of Orthopaedic Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan. eiren@is.icc.u-tokai.ac.jp Abstract We reviewed the surgical treatment of 31 patients with burst fractures or teardrop [ncbi.nlm.nih.gov]
Extension Treatment: SOMI - fuse if late instability 3. rotational- rotational ligament injuries assymetric disruption of the facet complexes- if combined with lateral compression, a fracture may accompany the ligamentous injury eg lat mass fracture Treatment [flinders.edu.au]
Non operative treatments include bracing, halo vest and cervical traction. Operative treatment consists of C1 -C2 fusion. [boneandspine.com]
In this article, the implications of radiologic findings for spinal stability are discussed in the context of surgical treatment planning. [appliedradiology.com]
Nonoperative treatments include brace (orthotic) treatment and medications. [uscspine.com]
Prognosis
The long-term prognosis of this injury mostly depends on the degree of neurological injury. [radiopaedia.org]
Brown- Sequard an injury to either side of the cord (hemisection) ipsilateral: muscle paralysis and jt position/ vibration loss contralateral: pain and temperature loss - good prognosis, 90% regain bladder / bowel function walk Central cord syndrome [flinders.edu.au]
(Outcomes/Resolutions) The long-term prognosis of Cervical Fractures depends on the severity of the injury, which can range from complete recovery to total paralysis (quadriplegia) The prognosis is usually good in individuals whose Cervical Fractures [dovemed.com]
[…] loss of stature of the anterior aspect of the vertebral body Serious fracture Occurs at lower cervical levels Unstable and frequently associated with spinal cord injuries Treatment Neck collar Restriction of activity Complications Cervical myelopathy Prognosis [learningradiology.com]
Differentiating this type of injury from the extension teardrop fracture, which is often far less severe, is important in guiding management and predicting prognosis. (8) 1. Torg J, Pavlov H, O'Neill M, Nichols C, Sennett B. [dx.doi.org]
Etiology
See all Unspecified fracture of unspecified vertebra ICD-10 Coding Teardrop Fracture ICD-9 Teardrop Fracture Etiology / Epidemiology / Natural History Etiology: axial load with concomitant flexion force creates large triangular bony fragment off the anteroinferior [eorif.com]
This system assists in determining prognosis and making treatment decisions. 18 The type I fracture is rare, seen in only 2 of 49 cases in the original series and 2 of 340 in the largest series published to date. 10,18 The proposed etiology is avulsion [appliedradiology.com]
(Etiology) Some common causes of Cervical Fractures include: A high-energy impact traumatic event such as an automobile accident A fall from a significant height Participation in any rough or high-impact sport Domestic violence, street fights Location [dovemed.com]
[…] narrower in comparison to the diameter of the spinal cord itself, so spinal cord injuries occur more frequently in cervical fractures below C3. 6 Any patient admitted to a trauma center or emergency care center with a mechanism of injury that fits the etiology [morphopedics.wikidot.com]
The etiology and incidence of the missed injury were determined. [crashingpatient.com]
Epidemiology
See all Unspecified fracture of unspecified vertebra ICD-10 Coding Teardrop Fracture ICD-9 Teardrop Fracture Etiology / Epidemiology / Natural History Etiology: axial load with concomitant flexion force creates large triangular bony fragment off the anteroinferior [eorif.com]
The epidemiology of fractures and fracture-dislocations of the cervical spine. Injury. 1992;21:38-40. Hadley MN, Dickman CA, Browner C, Sonntag VK. Acute axis fractures: A review of 229 cases. J Neurosurg. 1989;71:642-647. [appliedradiology.com]
View Article PubMed Google Scholar Sekhon LH, Fehlings MG: Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. 2001, 26 (24 Suppl): S2-12. 10.1097/00007632-200112151-00002. [sjtrem.biomedcentral.com]
Epidemiology of cervical spine injury victims. Ann Emerg Med 2001;38:12-16. 9. Schoenfeld AJ, Bono CM, Reichmann WM, et al. [ahcmedia.com]
Epidemiology of traumatic spine fractures. Injury. February 2009;40(2):166-172. 9. Richards P. Cervical spine clearance: a review. Injury. February 2005;36(2):248-269. Available from: MEDLINE, Ipswich, MA. 10. [morphopedics.wikidot.com]
Pathophysiology
View Article PubMed Google Scholar Sekhon LH, Fehlings MG: Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. 2001, 26 (24 Suppl): S2-12. 10.1097/00007632-200112151-00002. [sjtrem.biomedcentral.com]
It is associated with significant morbidity Pathophysiology (a) Anatomy Bony components: Vertebral body which gives the vertebrae its strength and weight bearing ability Vertebral arch formed by Pedicles and laminae which with the vertebral body form [rcemlearning.co.uk]
Compared to adults, children have a different fulcrum because of a relatively large head, the vertebrae are not completely ossified, and the ligaments are firmly attached to articular bone surfaces that are more horizontal, making the pathophysiology [emedicine.medscape.com]
Prevention
[…] burst the vertebral body, separating and displacing a wedge-shaped fragment of bone from the antero-inferior margin; such fractures are not usually associated with permanent neurologic sequelae Management Surgical fusion to stabilise the injury and prevent [medical-dictionary.thefreedictionary.com]
[…] vehicle Avoid jumping head first into shallow water spots Individuals who participate in any high-risk sports, such as football or hockey, should wear appropriate safety equipment to help prevent the possibility of any injury or bone fracture What is [dovemed.com]
Prevent falls by calling for help when you want to get out of bed. Traction: Traction uses weights to pull your bones back into place and to straighten the cervical spine. [drugs.com]
Occasionally there may be locking or 'perching' of the facet joints preventing the bones from returning to their normal positions. This may be unilateral or bilateral. [radiologymasterclass.co.uk]
These collars just help support the head while the neck is healing but they do not prevent movement so they are not good for unstable fractures. [morphopedics.wikidot.com]