3Atlanto- Occipital Dislocation Hyperextension and distraction mechanismDown’s syndrome, RA more susceptibleAsymmetric lateral masses on odontoid viewWidened predens spaceTreatment-Often fatalHighly unstableIf not fatal avoid traction
4Atlas Fractures Neural Arch Fracture of C1 Most common fracture of C1 Hyperextension injuryNot associated with neurologic deficitMay be confused with congenital abnormality
5Jefferson fracture Burst fracture of atlas (C1) Usually bilateral breaks in ant/ post archesVertical compression/ axial load injuryWidened lateral masses of C1 on open-mouth odontoid viewWidened predens spaceNeuro deficits uncommon
6Axis Fractures Odontoid fracture Incidence: 6% of cervical spine fracturesAssociated with atlas fractures in 8%HyperextensionOften forward subluxation of C1 on C2Odontoid fractureType IType IIType III
7Hangman’s Fracture Most common fracture of C2 Bilateral fracture of pedicles of axis (C2)Anterior slip of C2 on C3Mechanism: Sudden deceleration with hyperextensionMay or may not have anterior subluxationUnstable
8Compression Fracture Flexion injury Anterior wedging of 3mm or more suggests fractureUsually involves superior endplate of vertebral body
9Unilateral facet dislocation Mechanism: flexion, combined flexion/ rotationAnterior dislocation of one vertebral body by % on lateral viewOnly 30% associated with neurologic defect
10Bilateral Facet Dislocation Mechanism: flexion, combined flexion/ rotationAnterior dislocation of one vertebral body by 50% on lateral viewUnstableNeurologic deficits commonSeen in up to 85%
12Lumbar spine fractureThe lumbar vertebrae are the 5 largest and strongest of all vertebrae in the spine & it comprises the lower back.CausesTraumatic fractures Non-traumatic fractures
13Traumatic fractures caused by high-energy trauma, such as: Car crash Fall from heightSports accidentGunshot wound
14Non-traumatic fractures caused by a disease, such as:OsteoporosisMultiple myeloma (bone Tumour)Bone Metastasis
15Fractures types 1-Flexion Wedge Compression fracture A burst fracture 2- ExtensionChance fracture.3- RotationTransverse process fracture4- Fracture-dislocationSpondylolisthesis
16Wedge Compression fracture The vertebral body is compressed.the front of the vertebra is breaks.the back part does not effected.Most Common fracture & usually it is stable & painful #Cause by: an external force is applied to the spine, such as a fall or carrying of a sudden heavy weightRarely associated with neurologic problems.
17Burst fractureIs axial compression fracture in which the entire spinal vertebra breaks.The vertebra is break on both the front and back sides.Caused by a fall from a height and landing on the feet.
18Chance fractureIt is acute hyperflexion of the spine which distraction the posterior and impaction of the anterior vertebra.L1 and L2 most commonlyCommon symptom is a back pain
19Transverse process fracture Multiple avulsion fractures.Results from severe hyperextension and lateral flexionThe most common fractures are L2 and L3
20SpondylolisthesisThe vertebra (usually L5) is slips forward or backward compared to the next vertebra(usually the sacrum).it is more common in girls than boys.
21Symptoms:Low back painFeeling of “hamstring tightness”Pain radiating down the legsDifficulty with upright posture and gait
24Sacral Fracture What is a sacral fracture? A sacral fracture is a break in your sacrum. Which is a triangle-shaped (three sided) bone made up of five fused (joined) vertebrae. A sacral fracture more commonly occurs in older adults because they have weaker bones, Young, active people, may also get sacral fractures.
25What causes a sacral fracture? Sacral fractures are usually caused by an injury to the sacrum. These injuries can be caused by any of the following:1-Activities which are too hard for the sacrum to withstand.2-Car accidents.3-Fall from height.4-Having diseases that affect the bone, such as osteoporosis, or bone cancer.
27Sacral Stress Fractures : a sacral stress fracture occurs in young, active patients. These injuries are closely related to sacral insufficiency fractures described below, but the bone is usually not osteoporotic. Rather than the bone not being healthy enough, the activities simply are too much for the sacrum to resist, and a stress fracture results.
28Sacral Insufficiency Fractures Sacral insufficiency fractures usually are parallel to the spine. They are most often in the ala, just beside the sacroiliac joint, and sometimes there is also a transverse fracture. It is occur in elderly patients with osteoporosis. These fractures may be the result of a fall or may be the result of no particular injury.
29Sacral Insufficiency Fractures : Sacral insufficiency fractures may not be seen on regular x-rays, but usually show up on MRI or CT scans of the pelvis.
30Traumatic Sacral Fractures : Traumatic fractures of the sacrum can occur with pelvic fractures. These injuries commonly occur in car accidents and severe falls.
32Coccyx fractureThe coccyx is the final vertebral segments of the spinal column and is commonly called the tailbone. Tailbone fracture is a fracture to the small bone at the lower tip of the spine. Actual fractures of the tailbone (coccyx) are not common.Causes :A fall onto the tailbone in the seated position, usually against a hard surface, is the most common cause of coccyx injuries.The coccyx can be injured or fractured during childbirth.
33Coccyx dislocationThe dislocation of the coccyx occurs when there is a separation of the coccyx from the sacrum.The coccyx may displacement Backwards or forward.
34Causes :In order for the coccyx to be displaced, it must be subjected to a significant force. The two most frequent causes are:1-Falling on the tailbone, where the intensity of the fall displaces the coccyx.2-Labor, in which the fetus displaces the coccyx, usually backwards, during its passage through the birth canal. This can occur when the size of the baby and the size of the mother's pelvis are slightly out of proportion