tailieunhanh - Đặc điểm Chấn thương cột sống

Giải phẫu độc đáo của cột sống trên cổ tử cung và các cơ chế điển hình của thương tích mang lại nhiều dự đoán được các mô hình thương tích. Do chấn thương ligamentous của khớp và dây chằng ngang atlanto-chẩm atlantal là tương đối phổ biến, có một tiên lượng xấu cho việc chữa bệnh, | Upper Cervical Spine Injuries R. Sean Jackson MD Daxes M. Banit MD Alfred L. Rhvne III MD and Bruce V. Darden II MD Abstract The unique anatomy of the upper cervical spine and the typical mechanisms of injury yield a predictable variety of injury patterns. Traumatic ligamentous injuries of the atlanto-occipital joint and transverse atlantal ligament are relatively uncommon have a poor prognosis for healing and often respond best to surgical stabilization. Bony injuries including occipital condyle fractures atlas fractures most odontoid fractures and traumatic spondylolisthesis of the axis generally respond well to nonsurgical management. Controversy in management remains however especially with type II odontoid fractures. J Am Acad Orthop Surg 2002 10 271-280 The upper cervical spine or cervico-cranium includes the articulations of the occiput with the atlas and the atlas with the axis as well as the bony structures of the base of the skull axis and atlas. Injuries to this region are relatively common and generally occur as a result of significant forces applied to the head during trauma. Morbidity and mortality appear to be declining as a result of enhanced automobile safety measures and more attentive emergent However these injuries can be easily overlooked. The complex regional anatomy and overlying structures make plain radiographic images difficult to interpret. Delayed recognition or improper treatment can result in significant disability. The goals of treatment are to protect the neural structures reduce and stabilize the injured segment and provide long-term stability. A thorough understanding of the clinical presentation radiographic assessment and mechanisms of injury can minimize morbidity and enhance treatment effectiveness for the more common upper cervical ligamentous and bony injuries. Anatomy Unlike the subaxial spine each level of the upper cervical spine is anatomically unique with complex stabilizing structures Fig. 1 . The highly .