posterior cervical dislocation
Introduction
Introduction to posterior cervical dislocation Posterior cervical dislocation refers to the disease that causes the cervical vertebrae to produce over-extension and causes the lower edge of the upper cervical vertebrae to slide backwards on the upper edge of the lower vertebral body. The clinical symptoms are typical. Post-cervical dislocation is rare. Posterior cervical dislocation is one of the types of severe hyperextension injury. It is a complete injury, which is accompanied by extensive damage to the spinal cord and soft tissue, so the prognosis is poor. basic knowledge The proportion of illness: 0.025% Susceptible people: no specific population Mode of infection: non-infectious Complications:
Cause
Causes of posterior cervical dislocation
Violent injury (35%):
The violence acting on the face, forehead and ankle, such as causing excessive head and neck extension and its strength exceeds the tensile stress of the anterior longitudinal ligament, the ligament first breaks, and as the violence continues, the intervertebral space may be broken. The small joints are stretched and the joint capsule is torn, so that the posterior vertebral body of the upper vertebral body slides backward in the upper edge of the lower vertebral body and the posterior cervical dislocation occurs. Because of the most delicate spinal cord in various local tissues, When the spinal cord is embedded in the posterior margin of the superior vertebral body and between the anterior wall of the dural sac and the anterior border of the lower vertebral lamina and the ligamentum flavum, it is easy to cause different degrees of injury, generally manifested as central spinal cord syndrome, or Pre-spinal central artery syndrome and so on.
Congenital spinal stenosis (27%):
If the patient originally had a spinal canal stenosis, the injury may be aggravated and the spinal cord may be transected, resulting in complete spinal cord injury. In this case, the local ligament and the soft tissue such as the intervertebral disc are often seriously damaged, so the stability is poor. After the easy to automatically reset.
Excessive injury (25%):
Most of them are hyperextension injuries that cause this disease.
Prevention
Prevention of posterior cervical dislocation
The disease is a traumatic disease, no preventive measures, pay attention to safety, and avoid trauma.
Complication
Complications of posterior cervical dislocation Complications
The disease causes rupture of the posterior longitudinal ligament, posterior intervertebral disc tissue and pleats in the ligamentum flavum, which can constitute damage to the spinal cord, combined with quadriplegia.
Symptom
Cervical posterior dislocation symptoms Common symptoms Neck pain, neck and shoulder pain, cervical vertebrae have been known... Subcutaneous hematoma head and neck activity restricted feeling separation of limbs
Multiple overextension injuries, such as history of frontal facial violence. Older people are more common. Common lesions are concentrated in the 4-6 segments of the neck. There may be skin abrasions, contusions and subcutaneous hematomas on the face and forehead. Neck pain, neck dyskinesia, neck muscle spasm. More than 80% of cases are accompanied by clinical symptoms such as central nervous system syndrome or anterior central artery compression syndrome. The former is characterized by upper extremity than the lower extremities of the quadriplegic, sensory separation and reflex abnormalities; the latter is characterized by quadriplegia Wait.
Examine
Examination of posterior cervical dislocation
1. X-ray film: When the cervical vertebra violence disappears, due to the contraction of the neck muscles, the dislocated cervical vertebra may return to normal alignment, so the normal X-ray film may show normal signs, but the posterior structure may have small fracture pieces. The soft tissue of the anterior vertebrae is swollen and thickened.
On the lateral flexion of the flexion and flexion, the injury segment shows obvious instability, especially in the extension position, and the upper vertebral body moves backward. This is the opposite of the flexion injury, which is mainly characterized by the flexion of the upper vertebral body forward. Shift.
2. Magnetic resonance examination: due to the high rate of spinal cord injury, the magnetic resonance image can show the spinal edema of the damaged plane, signal, enhancement, cross-sectional image can show the gray matter of the spinal cord, the white matter boundary is blurred, in addition, the posterior small joint can still be displayed. The condition of the capsule is damaged.
Diagnosis
Diagnosis and differentiation of cervical dislocation
History of trauma
Mostly the mechanism of overextension injury.
2. Clinical manifestations
As mentioned above, the symptoms of local cervical and spinal cord involvement are predominant.
3. Imaging examination
(1) X-ray plain film: the anterior vertebral body shadow can be found on the lateral side of the cervical vertebrae, the frontal opening of the injured vertebrae intervertebral space is enlarged, and the avulsion fracture at the edge of the vertebral body is changed. Can show severe instability of the cervical vertebra.
(2) MRI examination: In addition to observing the changes of the vertebrae and intervertebral discs, it can also show the damage of the spinal cord and the posterior joint capsule, and can be compared with the X-ray plain film for comprehensive judgment.
It is not difficult to distinguish from other diseases by imaging examination.
