Treatment of fractures of the vertebrae C1 - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Neurosurgery

first cervical vertebra - the atlas - ring-shaped bone formation between the occipital bone and the second cervical vertebra - provides compounds of the skull bones (occipital) and spine, flexion-extension and rotation movements and lateral tilt it.The first vertebra has a body and a spinous process.The lateral mass of the atlas - two wedge-shaped bone - are joined in the ring arcs, the front and rear.Front lateral masses connected by a strong transverse ligament, which provides additional stability to the ring and prevents displacement of the atlas anteriorly.The first vertebra is worn on the odontoid process of the second vertebra.Around the tooth and there is a rotation of the atlas with the skull.

Weak muscular neck corset, the small size of the vertebrae makes it vulnerable to injury.Trauma "diver" - vertical compression, "whiplash" injuries during traffic accidents lead to serious injury of the cervical vertebrae and spinal cord until death.

ring C1 fractures often occur when axial tension,

more often combined with other injuries of the cervical vertebrae, in 50% of cases with a fracture of the second cervical vertebra - Axis.Damage to the atlanto - occipital connection can be caused by sudden tilting the head backward, falling on his head.When complete break ligamentous - articular structures with damage to the spinal cord - the lethal outcome.

Schematic representation of the atlas on the Jefferson fracture.

The following fractures of the first cervical vertebra:
1. fracture of the back arc,
2. broken the back of the arc at the junction with the lateral mass of the atlas,
3. fracture of the lateral masses of the vertebrae on the one hand,
4. fracture of the lateral masses of the vertebrae withone side of the rear of the arc from the side fracture fracture mass,
5. vertebral fracture lateral masses on the one hand with the back of the arc on the opposite side of a fracture.
6. explosive type fracture Jefferson fracture.Jefferson fracture - a fracture often four - two rear arch fracture and two front fracture.

in the development of stability plays the role of damaged ligament-muscular system.Fractures of the posterior arc basically stable, the front can be unstable and stable.

All the victims with neck injuries require hospitalization and carrying out X-ray, computer studies, and if necessary, magnetic resonance imaging, physical examination.

Treatments vary depending on the diagnosis and the individual patient's condition.In atlanto-occipital dislocation is possible to use arthrodesis and internal fixation, titanium strengthening vertebral structures, osteosynthesis, sometimes - skeletal traction.When an isolated fracture of C1 transverse ligament rupture without external fixation possible, with ligament rupture - external or surgical fixation.At the turn of Jefferson - fixation using galoapparata or occipital-cervical fusion.In the case of spinal cord injury requires decompression of the spinal cord and spinal stabilization.Perhaps a laminectomy.If surgical intervention is sometimes used general anesthesia with local premedication.The choice is made depending on the anesthesiologist in the general condition of the patient and the complexity of the surgery, its duration.The possibility of using endoscopic surgery, the use of rear or front access is solved individually, too.

Mainly used conservative treatment - traction halter, reposition, immobilization.All of the above - lasting treatments and serious injuries that can threaten a person's life - the choice of treatment - is the lot of a doctor.Task surgery - decompression of neurovascular structures of the spine;complete recovery in spinal axis prostran¬stve three-dimensional (3D);reliable fusion with an additional fixation of the vertebrae.

The rehabilitation period is recommended wearing a collar Schantz from one month to six, depending on the severity of damage to the atlas.

Collar Schantz

the presence of neurological complications (development of vertebral artery syndrome, vertebrobasilar-basilar insufficiency) - Rehabilitation of a neurologist.

neurologist Kobzev SV