Vertebral Fractures

Published on 16/04/2015 by admin

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Last modified 16/04/2015

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3 Vertebral Fractures

Anatomy of the Vertebral Column

image

Vertebral Column and Spine

Articulated Vertebrae and Spine

• Number: 31 = C7 + T12 + L5 + S5 + Co4
• Primary curvatures: thoracic, sacral; present in utero
• Secondary curvatures: cervical, lumbar; develop postnatally
• Curvatures dependent on body shapes and sizes and disc shapes and sizes
• Consequences of upright gait, large head, high-speed travel: major fracture forces typically are on cervical or lumbar vertebrae
• Physical landmarks for surgery

image C2-C3 disc: level of mandible
image C3 body: level of hyoid bone
image C4-C5 bodies: level of thyroid cartilage
image C7 spine: vertebra prominens
image T7 body: level of inferior angle of scapula
image L4-L5 disc: level of iliac crest

Typical Vertebrae

• Parts and landmarks: body, pedicles, lamina(e), spine, transverse processes, superior articular facets, inferior articular facets
• Associated rib components (variable): developmental (homeobox) anomalies can produce cervical and lumbar ribs.

Cervical Vertebrae

• C1, atlas

image No body, thin anterior and posterior arches, posterior tubercle, no laminae or spine
image Lateral masses with superior (atlantooccipital) and interior (atlantoaxial) articular facets
image No transverse foramina grooves for vertebral arteries entering foramen magnum

• C2, axis

image Body includes dens or odontoid process representing developmental C1 body.
image Broad lamina with bifid posterior process
image Large interarticular part with planar superior articular facet for C1, more typical inferior articular process for C3
image Strongest cervical vertebra

• Foramina transversaria

image Contain vertebral arteries from C6 through C2
image Anterior rims are rib components.

• C3-C7, typical cervical vertebrae

image Large, upward-cupped bodies
image Bifid spinous processes
image C6 and C7 spines are longest of the cervical vertebrae.
image Superior and inferior articular facets constrain flexion, extension, and lateral flexion.

Thoracic Vertebrae

• “Typical” vertebrae
• Synovial hemifacets on upper and lower body for heads of ribs; vertebral-costal joints
• Synovial facets on transverse processes for costotransverse joints with tubercles of ribs
image

Lumbar Vertebrae and Intervertebral Disc

Lumbar Vertebrae

• Largest bodies of all regional vertebrae, bear weight of body above
• Spinal foramina are larger superiorly, and spinal roots are larger inferiorly: L5 spinal nerves fit tightest.

Sacral Vertebrae

• Fusion of sacral bodies typically occurs in adulthood, though disc remnants can remain visible on imaging.
• Parts and landmarks

image Ala
image Sacroiliac articular surfaces
image Lumbosacral articular (disc) surface
image Promontory
image Fused bodies (5)
image Anterior and posterior foramina
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