- Discussion:
- includes lamina, pedicles, spinous processes, including supraspinous and
intraspinous ligaments, ligamentum flavum, & facet capsules;
-
Clay Shoveler's fx
-
Ligamentous Instability:
- consists of combined role of right & left
Facet Joint & lateral
masses in resisting compression;
-
ligamentous complex in posterior motion segment resists distraction
predominately thru the
Facet Joint capsules, and to lesser extent
thru interspinous ligaments;
(ligaments include:
Facet Joint capsules & interspinous ligaments)
- usually only one facet complex suffers from compressive failure;
- loss of compressive stability occurs when either the inferior or
superior articular process is fractured;
- whole lateral mass can be destabilized if the atatched pedicle and
lamina are fractured;
- w/ disruption may see
Facet Joint widening, & malalignment of
facet joints on
AP views.
- if vertebral body translation of > 3.5 mm occurs in conjuction w/ facet
dislocation, then middle
ligamentous complex is
disrupted as well;
- another fx thru the posterior elements is the "sentinel fx"
- this is characterized by fractures thru the lamina on either
side of the spinous process;
-significance of the sentinel fx is that the loose posterior
element may impinge on the Spinal Cord;
- otherwise there is no assoc injury and is considered stable;
- disruption of the posterior
ligamentous complex in the face of anaterior
fracture or dislocation is a strong indication of instability and of
potential necessity for surgical stabilization;
- exceptions may include the upper thoracic spine, which is inherently
more stable, and with bony
Chance Fracture;
-
compression frx of 3 sequential vertebrae leads to increase
in risk of posttraumatic
Kyphosis;
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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.
