spinal cord injury 3
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subluxation grading scale
divide the AP diameter of lower vertebral body into four parts, then ...
- 1 - it's .25 subluxed
- 2 - it's .5
- 3 - .75
- 4 - fully
- 3 or 4 is a dislocation
- a subluxed is named by the rel of the upper vert to the one below (so if C5 slides forward on C6, it's an ant. sublux)
where do most cervical spine injuries (those with survivors) take place?
75% in lower cervical spine
- 50% C5/6
- 12% C6/7
- 10% C4/5
ant and post arches of C1 break due to pressure from the lateral masses
- most common fx of the axis
- 10-15% of all cervical fractures
- fracture of both pedicles of axis vertebra (C2)
- usually due to forcible hyperextension (as seen in a hanging)
the part of the vertebra connection the body to the arch
4 types of fractures to the atlas and axis
- Jefferson (C1 arches)
- Ondontoid (C2)
- Hangman (C2 pedicles
- extension fracture with C2/3 pedicle
how to grade compression fractures
- type 1: tear drop fracture
- type 2: fracture lines are only in top
- type 3: top, bottom, not back
- type 4: complete
what cervical injuries are likely to come with a retro/dorsal hyperflexion accident?
- (acceleration injury)
- CIBI true fx at C2/3
- both pedicles of C2
- lacerate disc (at C2??)
what's the mechanism for 2/3 of all cervical injuries?
- ventro/anterior hyperflexion
- (decel injury - the reverse of whiplash)
an example of how skull calipers can introduce iatrogenic spinal cord injury
true vertical hyperextension due to overextension by callipers, stretching the cord
- loss of ability to thermoregulate below a spinal cord lesion (no shivering, no sweating, may need to use external things like blankets and ice packs)
- due to disconnection from hypothalamus
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