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SPINE TRAUMATOLOGY M. Krbec, M. Repko, M. Rouchal,

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Presentation on theme: "SPINE TRAUMATOLOGY M. Krbec, M. Repko, M. Rouchal,"— Presentation transcript:

1 SPINE TRAUMATOLOGY M. Krbec, M. Repko, M. Rouchal,
L. Ryba, R. Chaloupka Ortopaedic Univ. Dept. FN Brno-Bohunice

2 SPINE cervical C thoracic T lumbar L sacrum coccyx body support
spinal cord / dura protection

3 Anatomy of vertebra Vertebral body Pedicles Arch Articular processes
- superior - inferior Transverse processes Spinous process

4

5 Now 2-column theory(Magerl)
Denis 3-column theory Now 2-column theory(Magerl)

6 C1 C1 = atlas Arches + articular processes

7 C2 axis Body Dens Articular processes

8 Discus intervertebralis discus intervertebralis

9 EXAMINATION Clinical examination X-ray Neurological CT MRI
Case history

10 TYPES OF INJURY Forces, directions
Axial pressure Bending pressure Rotation Combination

11 MECHANISM OF INJURY Falls Traffic accidents Sport

12 Hematomyelia

13 Denis‘ classification 3 three-column concept
A compressive B burst C flection-distraction D rotational forces (shear, translation)

14 AO classification Magerl et al. 2-column compression distraction
A,B with rotation

15 Frankel classification
A complete loss of motor end sensory functions B no motor preservation, sensory function only C useless motor function preserved D motor function less than normal E normal neurological status

16 THERAPY conservative surgical orthosis, plaster cast bed rest
posterior surgery anterior surgery combined

17 FIRST AID CERVICAL SPINE FIXATION
TO AVOID MOVEMENT WITH THORACIC AND LUMBAR SPINE DURING MANIPULATION SPINAL DEPARTMENT

18 SURGICAL INDICATION NEUROLOGICAL LESION SPINE INSTABILITY
OPERATION UP TO 6 HOURS ! SPINE INSTABILITY

19 CONSERVATIVE THERAPY Bed rest Collars- soft -Philladelphia

20 CONSERVATIVE THERAPY T SPINE T8 - 12 Jewett orthosis LS SPINE
lumbar belt L4 - S1

21 HALO - TRACTION

22 CONSERVATIVE TREATMENT -plaster casts
C spine halo-cast, halo-vest Minerva cast / vest

23 CONSERVATIVE TREATMENT -plaster cast

24

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26 SURGICAL THERAPY DECOMPRESSION OF NEUROGICAL STRUCTURES
REDUCTION OF DEFORMITY HEALING WITH SOLID FUSION

27 SURGICAL THERAPY acute period
C spine anterior surgery T, L spine posterior surgery

28 BASIC PRINCIPLES OF SURGICAL THERAPY
reduction lordotisation stabilisation

29 POSTERIOR APPROACH TO THE T-L SPINE
Pedicle screws Bones Rods Cross-links

30 intersomatic fusion spongioplasty

31 POSTERIOR STABILISATION OF THE SPINE CT scan – TRANSPEDICULAR SCREWS

32

33

34 T-L SPINE – ANTERIOR SURGICAL APPROACH
replacing the vertebral body stabilisation

35

36

37 posterior instrumentation
Harms cage anterior instrumentation

38 Synex extended impl.

39

40

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42 C1,2 – SPINE INJURIES Rare, big violence on OC a C-SPINE
Occipital fracture C-1 arch fracture Odontoid C-2 fracture Body C-2 fracture CONSERVATIVE THERAPY

43 DENS FRACTURE

44 DENS FRACTURE

45 HANGMAN‘S C-2 FRACTURE TRAUMATIC SPONDYLOLISTHESIS OF AXIS

46

47 Anterior fusion and plate

48 CERVICAL SPINE INJURIES
Comminuted body fractures (burst) Injuries of discs and ligaments disc and ligamentous disruption Combined - teardrop, fracture dislocations

49 C- SPINE anterior surgery body replacement disc replacement
stabilisation

50 CERVICAL PLATES SYNTHES CASPAR

51 POSTERIOR SURGERY Hartshill

52 STABILISATION O-C ARTICULATION
Synthes Star Lock CerviFix ……..

53 HOOK PLATES disc and ligamentous disruption

54 POSTOPERATIVE AFTERTREATMENT
collar Jewett orthosis, lumbar belt plaster cast

55 Thank you for attention


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