- See:
Lower Cervical Burst Frx:
- Discussion:
- most severe fracture of cervical spine
- results from combination of extreme flexion & compressive forces
- commonly results from a dive into a shallow pool of water;
- associated w/ acute anterior cervical cord syndrome
- quadriplegia, loss of sensations of pain, temp, and touch;
- in adult, this frx occurs most commonly at C5-C6
- frx is unstable as result of complete disruption of both ligamentous and bony structures;
- type of flexion instability w/ failure of
anterior column and/or anterior & middle columns,
w/ concomitant disruption of posterior
ligamentous complex;
-
anterior column failure:
- when just the anterior column fails, the anterior vertebral body frx & posterior longitudinal ligaments fail;
- in this fracture the
middle column is intact and neurologic injuries are less common;
-
middle column failure:
- tear drop fracture dislocation involves major compression forces;
- w/ failure of middle column, there can be retropulsion of bone into the spinal canal (
burst frx);
- there is higher incidence of neurologic injury w/
middle column failure;
- tear drop may either involve an anteroinferior body fragment, or a posterior inferior fragment;
- the postero-inferior fragment may encroache into the canal and cause paralysis;
- Fracture Characteristics:
-
kyphosis at the level of injury
- kyphosis w/ posterior displacement of the spine above the level of the frx, and widening or
"fanning" of posterior ligamentous structures;
- vertebral body frx: - triangular frag off the anteroinferior body
- narrowing of the disc space
- widening of the interspinous and interlaminar spaces
- anterior dislocation / subluxation of articular fascets;
- posterior displacement of the involved vertebral bony fragments w/ varying degrees of
compromise of AP diameter of the canal;
-
burst frx &
hyperextension teardrop frx are associatted;
- on CT scan a characteristic finding of flexion tear drop fractures is saggital fracture
through the vertebral body;
The axial load teardrop fracture. A biomechanical, clinical and roentgenographic analysis.
