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Duke Orthopaedics
presents
Wheeless' Textbook of Orthopaedics

Anterior Column: the anterior half of the vertebral body



- See: Ligamentous Instability:

- Discussion:
    - 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