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4.2 of 78 Ratings
A 17-year-old male jumped headfirst into a shallow lake and sustained a comminuted C1 fracture. On exam, he is alert and oriented with normal motor and sensation in the upper and lower extremities. Which of the following radiographic parameters measurements suggests transverse ligament rupture?
Space available for cord 15 mm
Atlanto-dens interval 2 mm
Basion-dens interval 11 mm
Combined lateral mass displacement 9 mm
5 mm of prevertebral soft tissue swelling at C2
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A 28-year-old male patient dives head first into a shallow pool. He presents to the emergency room and radiographs and a CT are performed and shown in Figures A-D. Which of the following statements are true regarding these radiographic findings.
The transverse ligament is disrupted, the fracture is unstable and should be treated with either a rigid orthosis, halo immobilization, or surgical stabilization
The transverse ligament is intact, the fracture is stable and can be treated in a soft cervical collar
It is classified as Anderson and D'Alonzo Type II because the fracture extends into the C1/C2 facet
It is classified as Anderson and D'Alonzo Type III because the fracture extends into the C1/C2 facet
The imaging findings are relatively common and represent a congenital incomplete formation of the posterior arch and not a traumatic injury
A 35-year-old patient sustains a bilateral anterior and posterior arch (C1) injury with an intact transverse ligament. Which of the following treatment options is most appropriate?
Soft collar orthosis for 4-6 weeks
Rigid collar orthosis for 6-12 weeks
Posterior C1-C2 fusion
Figure A shows the coronal and axial CT images of a 27-year-old male that suffered a fall from a significant height. Which of the following radiographic measurements would best indicate disruption of the transverse ligament?
Atlantodental interval (ADI) of 2mm
Posterior atlanto-dens interval (PADI) of 16mm
C2 pars horizontal displacement of 3 mm
Combined lateral mass displacement of 8.2mm
A Power's ratio of 1.2
A Gallie C1-2 fusion with sublaminar wiring of C1 to the spinous process of C2 is a valid treatment option for which of the following injury patterns?
comminuted C1 burst fracture
type I odontoid fracture
type III odontoid fracture
transverse ligament disruption
Biomechanical studies have shown that an atlanto-dens interval of >7mm is likely associated with?
an intact transverse ligament, with ruptured alar and apical ligaments
a ruptured transverse ligament, with intact alar and apical ligaments
a ruptured transverse and apical ligament, with an intact alar ligaments
a ruptured transverse and alar ligament, with an intact apical ligaments
a ruptured transverse and alar ligament, and a ruptured tectorial membrane