What is Flexion teardrop fracture?

A flexion teardrop fracture occurs when flexion of the spine, along with vertical axial compression, causes a fracture of the anteroinferior aspect of the vertebral body. This fragment is displaced anteriorly and resembles a teardrop (see the image below).

What ligament is damaged in a teardrop fracture?

shearing/compression fracture along the anterior vertebral body, isolating a (classically) triangular anterior fragment and with rupture of anterior longitudinal ligament.

What is Nexus criteria?

The NEXUS criteria state that a patient with suspected c-spine injury can be cleared providing the following: No posterior midline cervical spine tenderness is present. No evidence of intoxication is present. The patient has a normal level of alertness. No focal neurologic deficit is present.

How serious is a teardrop fracture?

The tear drop fracture of the lower cervical spine is generally associated with a high incidence of neurological deficits and surgery is needed to treat this injury. Tear drop fracture of C2 is usually a stable fracture that is amendable to conservative treatment.

Is a teardrop fracture unstable?

Teardrop fracture is the most severe1 and unstable injury of the cervical spine resulting in permanent quadriplegia in the vast majority of cases2–4 and even death.

Is an extension teardrop fracture unstable?

Extension teardrop fractures are stable in flexion and unstable in extension as the anterior longitudinal ligament is disrupted. Extension teardrop is not considered as severe as flexion teardrop fractures.

When should I clear my C collar?

The goal is to clear the C-spine within four hours. If there is a significant painful “distracting” injury, then the goal is to clear the C-spine in less than 12 hours. iii. If the CT shows abnormalities, then the orthopedic or neurosurgical spine service should be consulted prior to removing the collar.

What are Nexus and C-spine criteria?

Clears patients from cervical spine fracture clinically, without imaging. The NEXUS Criteria represent a well-validated clinical decision aid that can be used to safely rule out cervical spine injury in alert, stable trauma patients without the need to obtain radiographic images.

How long does a teardrop fracture take to heal?

The duration for bony union was a mean of 13.0 weeks (11.4 to 16.4 weeks) (Table 2).

What is an extension teardrop fracture?

Extension Teardrop Fractures of the cervical spine are subaxial cervical spine fractures caused by forced extension of the neck with resulting avulsion of the anteroinferior corner of the vertebral body.

What is spinal shock syndrome?

Spinal shock is the altered physiologic state immediately after a spinal cord injury (SCI), which presents as loss of spinal cord function caudal to the level of the injury, with flaccid paralysis, anesthesia, absent bowel and bladder control, and loss of reflex activity.

What causes a teardrop fracture?

Teardrop fracture is caused by high-energy axial compression of the flexed cervical spine due to trauma involving head impact such as: diving into shallow water, fall from high height, motor vehicle crash, or sports impact.

Can you clear a cervical spine with imaging alone?

Computed tomography alone may clear the cervical spine in obtunded blunt trauma patients: a prospective evaluation of a revised protocol.

Can you clear c spine with CT?

Negative MPR CT clears the C-spine and allows the ED team to remove the C-collar in case of a reliable examination. The examination must exclude any motor compromise or any neurological symptoms in discrepancy with the imaging in alert patients.

Which radiographic findings are characteristic of a flexion teardrop fracture?

Radiographic features Flexion teardrop fractures most commonly occur at mid/lower cervical spine, specifically at C4, C5, or C6 1,2. The most characteristic findings include: fracture of the anteroinferior lip of vertebral body

What is the mechanism of injury for a teardrop fracture?

The mechanism of injury may be flexion (unstable) or extension (stable). A flexion teardrop fracture is the most severe fracture of the cervical spine. Often, such injuries occur after dives into shallow pools of water.

Is this a C5 flexion teardrop fracture?

There is a C5 flexion teardrop fracture. Notice that the lower cervical area is not visualised well and additional imaging is required. The CT-images demonstrate the extreme axial loading.

What is the difference between a flexion teardrop fracture and Jefferson fracture?

Flexion teardrop farcture is the result of extreme flection with axial loading. It is unstable and is associated with a high incidence of cord damage. Traumatic spondylolisthesis of C2. ‘Open mouth fracture’. Jefferson fracture is a burst fracture of the ring of C1 with lateral displacement of both articular masses .