Cervical vertebral fracture with dislocation injury
Introduction
Introduction to the injury of cervical spine fracture with dislocation Refers to the simultaneous occurrence of vertebral fracture and vertebral dislocation. This typical complete injury is not uncommon in clinical practice, and is often accompanied by spinal cord injury. It occurs in the neck 4~5, neck 5~6 and neck 6~7. Three cervical segments are severe types of cervical spine injuries. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: spinal cord injury
Cause
Causes of injury to cervical spine fracture with dislocation
(1) Causes of the disease
Flexion, extension, and vertical compression can cause injury.
(two) pathogenesis
1. Flexion and compression violence: that is, at the same time causing vertebral compression fracture, the posterior small joint also dislocation. When the axial squeezing and compression combined with the violent action on the cervical vertebra, it can cause multiple structural damage of the cervical spine. for:
(1) Vertical vertebral cleft palate (orthogonal X-ray fracture): It may be an axial load acting on the fracture caused by the bilateral Luschka joint.
(2) Acromioclavicular fracture of the anterior and posterior margin of the vertebral body: mainly due to flexion and violence, when the vertebral body is displaced backward.
(3) Vertebral body compression and advancement: that is, the fractured vertebral body is displaced backwards on the lower vertebral body.
(4) vertebral compression and backward displacement: bilateral vertebral or laminar fractures at this time; unilateral fractures are less than 3% to 5%.
The above four fractures are the most unstable in cervical spine injury. Among them, the posterior displacement of the vertebral body indicates three-column injury, with intervertebral disc, intervertebral ligament and anterior and posterior longitudinal ligament rupture, and the posterior structure looks normal. However, it is not reliable. This kind of injury can cause the cervical vertebrae to be obviously unstable. Complete spinal cord injury occurs almost without exception. This kind of flexion-compression injury is mostly caused by diving or snorkeling.
2. Compressing violence
Contrary to the former, it is a compression injury in the posterior extension state. In this case, multi-segment bilateral laminar fractures may occur, and often a continuous multi-segmental lamina fracture, causing "trauma."
Sexual laminectomy, due to its backward displacement, there is very little spinal cord injury. At this time, if there is anterior column rupture and intervertebral separation (more common in the elderly, it is common in the neck 6-7 damage after the fall injury).
3. Vertical sexual violence
At the same time as the vertebral body burst fracture, due to the rapid loss of the height of the vertebral body, the facet joint appears semi-dislocation or interlocking sign.
4. Vertical + flexion violence
As the wedge deformation of the vertebral body intensifies, the posterior small joints are also displaced, and can be developed from subluxation to total dislocation.
The injury of this group of cases is more serious, and its pathological anatomy is more complicated, and each case has differences. It needs to be analyzed and observed on a case-by-case basis.
Prevention
Prevention of injury of cervical spine fracture with dislocation
Prevent violent injuries.
Complication
Injury complications of cervical fracture with dislocation Complications spinal cord injury
Often complicated by complete spinal cord injury.
Symptom
Cervical vertebrae fracture with dislocation injury symptoms common symptoms dyspnea consciousness blurred eye-head reflex disappears
1. The general symptoms of cervical spine injury are more serious.
2. Spinal cord injury
Except for the "lucky injury" with a wide sagittal diameter of the spinal canal, there are generally different degrees of sputum signs, and the proportion of complete spinal cord injury is higher.
3. Complications
Due to serious injuries, often due to respiratory muscle paralysis and other breathing difficulties, and secondary to falling pneumonia; prone to hemorrhoids, etc., should be checked.
Examine
Examination of cervical spine fracture with dislocation injury
The determination of fracture and dislocation is mainly based on X-ray film and CT scan; however, the judgment of soft tissue injury and spinal cord state is still clear with MRI images, and should be checked early.
Diagnosis
Diagnosis and diagnosis of cervical spine fracture with dislocation
History of trauma
Many are caused by strong trauma.
2. Clinical manifestations
As mentioned above, the symptoms are more complicated and critical and should be thoroughly examined.
3. Imaging examination
The determination of fracture and dislocation is mainly based on X-ray film and CT scan; however, the determination of soft tissue injury and spinal cord state is still clear with MR images, and should be checked early.
