![]() ![]() 5 A locked C2–C3 facet joint constitutes a type III lesion in both classification systems. Hangman's fractures (axis ring fractures) are classified by Effendi et al and modified by Levine and Edwards. Type 2 odontoid fractures are further classified by Apfelbaum into 3 subtypes, depending on the direction of the fracture line: type 2a, where the line is anterior oblique type 2b, where the line is posterior oblique and type 2c, where the line is horizontal. Anderson and D'Alonzo classified odontoid fractures into 3 types. Atlas fractures are classified into type I (posterior arch fractures), type II (anterior arch fractures), type III (Jefferson fracture), type IV (lateral mass fractures), and type V (transverse fractures of the anterior arch). 4 Occipital condyle fractures are classified by Anderson and Montesano. There is no universally accepted classification system for upper cervical injuries, such as the Subaxial Injury Classification System) and the Thoracolumbar Injury Classification System. Therefore, the fusion of these segments would undoubtedly cause this motion to be permanently lost. 1, 2 The C1–C2 complex allows 50% of all the rotation of the entire spine and 10° of flexion-extension and 50 degrees of axial rotation. Other ligaments supporting the cervical spine are anterior and posterior longitudinal ligaments along with the posterior ligament complex. The apical, alar, and cruciate ligaments constrain the movements of the atlanto-axial articulation. It is composed of occipital condyles, the atlas, and the axis along with atlanto-occipital and atlanto-axial joints. It is essential to be familiar with the complex anatomy and kinematics of the upper cervical spine. ![]()
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