Anterior Column: the anterior half of the vertebral body
- See: Ligamentous Instability:
- antatomic structures in the anterior column that resist compression forces are the vertebral body centrum and intervertebral disc;
- structures that counter act tensile forces in anterior motion segment are anterior longitudinal ligament and the annulus fibrosis;
- stable injuries to anterior column include compression frx of < 25% loss of vertebral body ht. & anteroinferior avulsion frx
where the fragment width is < 20% of vertebral body width;
- unstable injuries to anterior column include compression frxs w/> 25% loss of ht indicating posterior ligament rupture,
and fractures thru the vertebrae;
- fracture lines extend thru vertebral body centrum in coronal plane represent anterior collumn failure;
- anterior ligamentous disruptions can be detected by the presence of small anteroinferior avulsions and segmental disc widening;
(ligaments include: ant. longitudinal lig. & Annulus fibrosus)
- w/ complete cervical dislocation from anterior ligament failure, more stable internal fixation (posterior plate stabilization) should be
considered to permit early patient mobilization;
- note: failure of the anterior vertebral body should always suggest posterior ligament failure;
- if posterior ligament failure is ruled out, then treat patient w/ hard collar;
- w/ posterior ligament disruption (or w/ Middle column collapse)
- treat w/ gradual traction, reduction, & posterior stabilization & then fusion
The three column spine and its significance in the classification of acute thoracolumbar spinal injuries.
Spinal instability as defined by the three-column spine concept in acute spinal trauma.
Complications in three-column cervical spine injuries requiring anterior-posterior stabilization.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Thursday, December 22, 2011 11:59 am