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Fracture of the cervical spine

Fractures of the spine are the result of great force. Depending on the nature and direction of the applied force , the spine " break " in various places. Typical of rear-end collisions at high speed, but also for sports injuries, where the cervical spine is severely stressed, the dens fracture, ie Breakage of the second Cervical vertebra. It can shave off right at the base of the dens . Behind it is the brain stem, that is the center, where the vital function of respiratory and cardiovascular be controlled, but also the direct link to the cerebrum and thus also to the motor system. The dens is in its mobility controlled by bands, so it is especially not to bruise the brain stem at the head bends. Tear these ligaments as a result of force application also, then this can have fatal consequences. If this causes a contusion of thebrain stem that is often associated with the instant death at the accident site. Fortunately, the victim and this is initially without consequences, so the correct recovery at the scene and transport to the nearest hospital is particularly important. In principle, that every accident has injured an unstable spine, until the contrary is proved. This means that it must be transported at a cervical collar and on a vacuum mat. It was only in the hospital can be assessed by X-ray and CT, the extent of the injury. If a dens fracture is diagnosed, it is important to assess what type of fracture it is. In a so-called Anderson and D' Alonzo type II fracture , there is a high risk of instability and thus risk of injury to the brain stem. Therefore patients should be operated with such fractures and the fracture to be stabilized. Often a direct Dens fixation is possible.
It can also lead to more complex instabilities in the upper cervical spine. These may affect the first two cervical vertebrae , but also the head - cervical joints. Specifically, after a CT scan and 3D reconstruction - is decided whether a stabilization operation is needed - when the position of the articular surface and the breaking lines is judged . Stability operations is always trying " motion preserving " to stabilize, ie as little as possible. Sometimes, however, can be called a occipitocervicale stabilization, ie not avoid the involvement of the head and neck joint. Patients are thus considerably restricted movement. especially in the look down and in rotation of the head . Such complex operations are for example in rheumatoid arthritis sometimes necessary.