Upper Cervical Spine Fractures

Upper Cervical Spine Fractures
Presentation lecture by:Daniel Gelb, MD

Upper Cervical Spine Fractures

* Epidemiology
* Anatomy
* Radiology
* Common Injuries
* Management Issues

Upper Cervical Spine Fractures
* Epidemiology
o Cause
+ MVC 42%
+ Fall 20%
+ GSW 16%
o Gender
+ Male 81%
+ Female 19%

Etiology of Spinal Cord Injury by Age
Upper Cervical Spine Fractures
Upper Cervical Anatomy
C1 - Atlas
Anatomy – The Atlas
C2 Anatomy
Anatomy – The Axis
Anatomy – The Ligaments
AtlantoAxial Anatomy
Tectorial Membrane
AtlantoAxial Anatomy
occiput
Tranverse Ligament
C1-C2 joint
Alar Ligament
AtlantoAxial Anatomy
Transverse
Ligament
Facet for Occipital Condyle


AtlantoAxial Anatomy
Vertebral
Artery
Radiographic Evaluation
Plain Radiographic Evaluation
Lateral View
Open Mouth AP
Radiographic Diagnosis – Screening Lines
Powers’s Ratio
Harris’s lines
Radiographic Lines
Powers’ Ratio
Radiographic Diagnosis
CT Scan
MRI
Upper Cervical Spine Fractures
Occipital Condyle Fracture
OccipitoAtlantal Dissociation (OAD)
Commonly Fatal
OccipitoAtlantal Dissociation (OAD)
Occipital Cervical Dissociation
Transverse ligament avulsion
Atlas Fractures - Treatment
Fusion options
Gallie
Brooks Jenkins
Transarticular Screws
C1 lateral mass/C2 pars-pedicle screws
Atlas Fractures - Treatment
Odontoid Fractures
Etiology Bimodal distribution
Odontoid Fractures
Treatment Options
odontoid fractures
Type 1
Type 3
Type 2
Type II Fracture Nonunion Risk Factors
Anterior Odontoid Screw Fixation
Indications
Contraindications
Posterior Odontoid Fixation
C1 lateral mass screws
Traumatic Spondylolisthesis Axis
Hangman’s Fracture
Hangman’s Fracture Treatment
Halo Immobilization
Elderly and Halo-vest Treatment

Upper Cervical Spine Fractures.ppt