1. Presented by M.A. Kaeser, DC Spring 2009
Cervical Spine
Presented by M.A. Kaeser, DC
Spring 2009

2. Radiographic Anatomy APOM Dens C1 Lateral masses C1 Posterior arch
C1 Anterior arch
C1 TPs
Atlanto-occipital joint
Mastoid air cells
C2 spinous process
C2 transverse foramen
Mandible

3. Radiographic Anatomy Lateral view C1 posterior tubercle
C1 posterior arch
C1 lateral mass
Dens
C2-C7 bodies
IVDs
Articular pillars
Facets
Laminae
SPs
Spinolaminar line
TPs
Soft tissue space (PLT)
Thyroid cartilage and larynx
Hyoid bone
Angle of mandible
Mastoid air cells

4. Radiographic Anatomy
48C/3B7/51F/1B1/ADD/157/40/a1198_19.JPG

7. Level of C5/6 Disc 1 = SCM 2 = CCA 3 = Thyroid cartilage
4 = Laryngopharynx
5 = Piriform recess
6 = Trapezius
7 = SP
8 = TP
9 = C5/6 disc
10 = Vertebral a.

8. Level of C4 1 = vertebral artery 2 = mandible 3 = hyoid bone
4 = laryngeal space
5 = ICA
6 = IJV
7 = body C4
8 = Spine
9 = Lamina
10 = SCM

9. Radiographic Anatomy APLC SPs Laminae Pedicles TPs Articular pillar
Uncovertebral joints
Costotransverse joint
Trachea
IVFs
Lung apices

10. Specific Problems Dislocations Atlantooccipital dislocation (unstable)
Facet joint dislocation (unstable)

11. Atlantooccipital Dislocation
Caused by complex injury
Usually causes death
Causes an increase in
prevertebral soft tissue width

12. Facet Joint Dislocation
Three types
Subluxed facets, perched facets, locked facets
Best seen on lateral view
Step deformity, >3 mm
Occur secondary to hyperflexion
Disruption of ALL, IVD and
posterior ligaments

13.
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14. Fractures Unstable Stable Flexion Teardrop Hangman’s
Hyperextension fracture dislocation
Burst
Jefferson’s
Odontoid
Stable
Clay Shoveler’s
Wedge
Extension Teardrop

15. Unstable Fracture Flexion Teardrop Extremely unstable
Posterior displacement
of the vertebral body
Disruption of all ligaments
and IVD
Often results in anterior
spinal cord compression

17. Unstable Fracture Hangman’s Bilateral C2 pedicle fracture
MVAs or hangings
Anterior displacement
of the anterior part of C2

18.
16yocervicaltrauma_fig3b-99.jpg

19. Unstable Fracture Hyperextension fracture dislocation

21. Unstable Fracture Burst Fracture Axial injury Loss of anterior
and posterior body
height
Bony fragments may
push on the spinal
Cord
M/C in mid C/S

22.
aa1abAfbeelding-9.jpg

23. Unstable Fracture Jefferson’s At least two fractures of C1
Secondary to an
axial injury
Diving
Heavy object
large/g00mc20l16x.jpeg

24.
surgery/ jpg

25. Unstable Fracture Odontoid Fractures Type 1 Type 2 – most unstable

26. Type I http://download.imaging.consult.com/ic/images/
S /gr12a-midi.jpg

27. Type II

28. Type III

29. Stable Fracture Clay Shoveler’s Secondary to a flexion injury
Avulsion of a piece of SP
M/C in lower C/S

31. Stable Fracture Wedge Flexion injury Compression of anterior portion
of vertebral body
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32. Stable Fracture Extension Teardrop Avulsion of a piece of the
anteroinferior portion
of a vertebra
Often occurs at C2
caseofweek/caseoftheweekpix2008/
cow302lg.jpg

33.
S /gr1-midi.jpg