Spine Pdf

Dr. Sulastri C. Panjaitan, Sprad

SPINE

Anatomi

Cervikal

Thoracal

Lumbal

Trauma  Cervikal  Jefferson fracture  Burst fracture of the ring of C1  Classically, it involves fractures of the anterior

arch of C1 on both the right and left sides and the posterior arch of C1 on both the right and left sides

 Conventional radiography Open-mouth (odontoid) view is the most revealing  Classically there is bilateral, lateral offset of C1 on

C2

 Lateral view:  May show prevertebral soft tissue swelling anterior to

C1  Pre-dentate space (distance between the anterior tubercle of C1 and the dens) may be widened to greater than 3 mm if there is damage to the transverse ligament

 Hang man’s fracture  Hangman fracture (also known as traumatic

spondylolisthesis of axis) is a fracture which involves the pars interarticularis of C2 on both sides, and is a result of hyperextension and distraction.

 Radiographic features  bilateral lamina and pedicle fracture at C2  usually associated with anterolisthesis of C2

on C3

 Burst fracture  Seen in the lower cervical vertebrae (C3-7).  Typically, the posterior fragment is posteriorly displaced and may cause injury to the spinal cord.  Radiographically, it is characterized by a vertical

split in the vertebral body, as seen on the anteroposterior view, but the lateral projection or lateral tomography better demonstrates the extent of comminution and posterior displacement

Toracolumbal

fracture

kompresi

Kompresi T8

 Spondylolysis and Spondylolisthesis  Spondylolysis, a defect in the pars

interarticularis (neck of the “Scotty dog”) of a vertebra, may be an acquired abnormality, secondary to an acute fracture, or, as is more commonly the case, it may result from chronic stress (stress fracture).

 Spondylolisthesis, a term introduced by

Killian in 1854, is defined as ventral slipping or gliding of all or part of one vertebra on a stationary vertebra beneath it

Grade spondylolisthesis

Degenerasi diskus intervertebralis  Radiografi menunjukan:  Penyempitan diskus, pembentukan osteofit, bony

endplate eburnation “discogenic sclerosis”, vacuum phenomenon

Vacuum phenomenon

Differential diagnosa

Ankylosing Spondylitis

LSTV (lumbosacral transtitional vertebrae)

 LSTV are congenital spinal anomalies defined

as either sacralization of the lowest lumbar segment or lumbarization of the most superior sacral segment of the spine.

Sakralisasi L5

Lumbalisasi S1

Castellvi’s classification