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Upper Cervical Trauma: Fractures, Classification and Treatment Options

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Sohail Bajammal
Sohail Bajammal

Upper cervical (craniocervical) trauma: diagnosis & management. The presentation was done in 2006.

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Upper Cervical Trauma Sohail Bajammal, MBChB, MSc November 14, 2006 St. Joseph’s Healthcare, Hamilton Weekly Orthopaedic Teaching Rounds
Upper Cervical Trauma a.k.a. Cranio-cervical Trauma Occipito-cervical Trauma Occipito-atlanto-axial Trauma
Outline ,[object Object],[object Object],[object Object],[object Object]
The Problem ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anatomy
Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Courtesy of AnatomyTV
 
 
 
 
 
 
Ponticulus Posticus Latin , little posterior bridge ,[object Object],[object Object]
Ponticulus Posticus
Ponticulus Posticus
X-rays
Cervical X-rays ABCDEs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lateral C-spine
Harris Lines SAC: > 13 mm
[object Object],[object Object],[object Object],[object Object],[object Object],Powers’ Ratio
Open-mouth View
Occipital Condyle Fractures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Occipito-cervical Dissociation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Traynelis Classification of Occipito-cervical Dissociation
Harborview Classification of Occipitocervical Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atlas (C1) Fractures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atlas Fractures ,[object Object]
Stable Atlas Fractures ,[object Object],[object Object],[object Object]
Unstable Atlas Fractures ,[object Object],[object Object]
Plough Fracture
Rupture of Transverse Ligament ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atlanto-Axial Instability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rotatory Atlanto-Axial Instability Collar or Halo C1-C2 Fusion
Axis (C2) Fractures ,[object Object],[object Object]
Odontoid Fractures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Type I Odontoid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Type III Odontoid ,[object Object],[object Object],[object Object],[object Object]
Type II Odontoid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Type II Odontoid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Options for High Risk type II ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anterior Odontoid Screw
Traumatic spondylolisthesis of the Axis (Hangman's fracture) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hangman's Fracture Effendi  Levine & Edwards Classification
Type I Hangman’s ,[object Object],[object Object],[object Object]
Type IA Hangman’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Type IA Hangman’s
Type II Hangman’s ,[object Object],[object Object],[object Object]
Type IIA Hangman’s ,[object Object],[object Object],[object Object],[object Object],[object Object]
Type III Hangman’s ,[object Object],[object Object],[object Object],[object Object],[object Object]
Posterior C1-2 Fusion Gallie Technique
Posterior C1-2 Fusion Brooks-Jenkins technique
C1–C2 Transarticular Screw Fixation Magerl technique
Finally.. It’s over!
Halo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Halo ,[object Object],[object Object],[object Object],[object Object],[object Object]
Halo Care ,[object Object],[object Object],[object Object],[object Object]
Halo Care ,[object Object],[object Object]
 
 

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