L3 Transverse Process Fracture

Sacrum

Figure 1-2. Lateral radiograph of the lumbar region. Note that the zygapophyseal (facet) joint that is formed between the inferior (12) and superior (8) articular processes is inclined somewhat vertically. Because of this orientation, dislocations occur only with an accompanying fracture of the thoracic or lumbar vertebrae. Note the close relation between the zygapophyseal (facet) joint and the intervertebral foramen (2), which transmits the spinal nerve. Because facet joints are synovial joints, rheumatoid arthritis may impinge on the spinal nerve and cause severe pain. The sacral promontory is the anterior edge of vertebral body S1 (14) and is an important obstetric landmark. (Reprinted with permission from Fleckenstein P, Tranum-Jensen J: Anatomy in Diagnostic Imaging. Philadelphia, WB Saunders, 1993, p 124.)

Dog Eye And Facet JointTransverse Process Fracture

1.12th rib 6. Superior articular process of sacrum

2. Zygapophyseal (facet) joint L1-2 7. Inferior articular process of L2

3. Superior articular process of L3 8. Transverse process of L3

4. Pedicle of vertebral arch L3 (eye of "Scottie dog") 9. Zygapophyseal (facet) joint L2-3

5. Transverse process of L3 (snout of "Scottie dog") 10. Lamina of vertebral arch L4

Figure 1-3. Oblique radiograph of the lumbar region ("Scottie dog" projection). The anatomic structures of the lumbar vertebrae make a Scottie dog shape. Spondylolysis is a chronic stress fracture of the pars interarticularis [an area between the pedicle (4) and the lamina (10)]. The fracture (dotted lines) appears as a "collar" around the neck of the Scottie dog. (Adapted with permission from Fleckenstein P, Tranum-Jensen J: Anatomy in Diagnostic Imaging. Philadelphia, WB Saunders, 1993, p 125.)

Caudal Vertebral Body

Vertebral Column 9 7

1. Body of 12th thoracic vertebra

2. Basivertebral vein

3. Lumbar artery and vein

4. Cauda equina

5. Intervertebral disk L2-3

6. Subarachnoid space

7. Spinal cord

8. Conus medullaris

9. Epidural fat

10. Spinous process of L2

11. Ligamentum flavum

12. Supraspinous ligament

13. Caudal termination of subarachnoid space

14. Sacral canal

Figure 1-4. Median sagittal MRI scan of the lumbar region. Note the basivertebral vein (2) that connects the internal vertebral venous plexus and the external vertebral venous plexus, all of which are involved in the metastasis of breast, lung, or prostate cancer to the brain. Note that the supraspinous ligament (12) continues cranially to the cervical region as the ligamentum nuchae (see Figure 1 -1, label 17), and that the ligamentum flavum (11) connects the laminae of two adjacent vertebrae. (Reprinted with permission from Fleckenstein P, Tranum-Jensen J: Anatomy in Diagnostic Imaging. Philadelphia, WB Saunders, 1993, p 129.)

Hyperflexion

Hyperflexion

Cervical Ligamentum Flavum Anatomy

Figure 1-5. Teardrop hyperflexion injury. From a strictly anatomic perspective, hyperflexion of the cervical flexion will stretch or tear the posterior longitudinal ligament. (>4) The injury has the following classic components (although variations occur, depending on the severity of the injury): avulsion fracture of a cervical (C5 shown) vertebral body ("teardrop body"), fracture of the spinous process, posterior subluxation of vertebrae, compression of the spinal cord, tear of the anterior longitudinal ligament (AL), and tear or disruption of the posterior longitudinal ligament (PL), ligamentum flavum (LF), interspinous ligament (IS), and supraspinous ligament (SS). (B) Lateral radiograph of a teardrop hyperflexion injury. Note the avulsion fracture of vertebral body C5 ("teardrop body"; dotted line) and the posterior subluxation of vertebra C5. (Adapted with permission from Levy RC, Hawkins H, Barsan WG: Radiology in Emergency Medicine. St. Louis, CV Mosby, 1986, p 78.)

Posterior Avulsion Fracture

Figure 1-5. Teardrop hyperflexion injury. From a strictly anatomic perspective, hyperflexion of the cervical flexion will stretch or tear the posterior longitudinal ligament. (>4) The injury has the following classic components (although variations occur, depending on the severity of the injury): avulsion fracture of a cervical (C5 shown) vertebral body ("teardrop body"), fracture of the spinous process, posterior subluxation of vertebrae, compression of the spinal cord, tear of the anterior longitudinal ligament (AL), and tear or disruption of the posterior longitudinal ligament (PL), ligamentum flavum (LF), interspinous ligament (IS), and supraspinous ligament (SS). (B) Lateral radiograph of a teardrop hyperflexion injury. Note the avulsion fracture of vertebral body C5 ("teardrop body"; dotted line) and the posterior subluxation of vertebra C5. (Adapted with permission from Levy RC, Hawkins H, Barsan WG: Radiology in Emergency Medicine. St. Louis, CV Mosby, 1986, p 78.)

Scan Rotary Subluxation

Figure 1-6. Jefferson fracture. (>A) The injury has the following classic components: fracture of vertebra C1 at multiple sites, lateral displacement of vertebra C1 beyond the margins of vertebra C2 (arrows), and tear of the transverse ligament (TL). (B) CT scan of a Jefferson fracture. Fracture of vertebra C1 at multiple sites (arrows). D = dens. (B adapted with permission from Levy RC, Hawkins H, Barsan WG: Radiology in Emergency Medicine, St. Louis, CV Mosby, 1986, P 70.)

Ligament Damage And

Figure 1-6. Jefferson fracture. (>A) The injury has the following classic components: fracture of vertebra C1 at multiple sites, lateral displacement of vertebra C1 beyond the margins of vertebra C2 (arrows), and tear of the transverse ligament (TL). (B) CT scan of a Jefferson fracture. Fracture of vertebra C1 at multiple sites (arrows). D = dens. (B adapted with permission from Levy RC, Hawkins H, Barsan WG: Radiology in Emergency Medicine, St. Louis, CV Mosby, 1986, P 70.)

Normal ScanLigament Damage And

Figure 1-7. Hangman fracture. From a strictly anatomic perspective, hyperextension of the cervical column will stretch or tear the anterior longitudinal ligament. (>A) The injury has the following classic components: bilateral fracture of the pars interarticularis of vertebra C2, anterior subluxation of vertebra C2, and tear of the anterior longitudinal ligament (AL). (B) Lateral radiograph of a hangman fracture. Note the fracture of the pars interarticularis of vertebra C2 (solid arrow) and the anterior subluxation of vertebra C2 (open arrow). (C) In a legal drop hanging, the posterior fractured portion of C2 remains attached to C3, and the distance between C2 and C3 is increased so that the spinal cord is stretched, causing death. [B adapted with permission from Osborn AG: Head trauma. In Eisenberg RL, Amberg JR (eds): Critical Pathways in Radiology. Philadelphia, JB Lippincott, 1981.]

Hyperextension

What Does Subluxation Spine Look Like

Hyperextension

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Responses

  • severi v
    What are the causes of a stretched pedicle and a widend facet joint?
    4 years ago
  • natsnet
    What causes a scottie fracture?
    15 days ago

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