Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Vaccaro, Alex; Schweitzer, Mark E.; Flanders, Adam E.

doi:10.1007/s00256-006-0115-3

Cited by 26 publications

(10 citation statements)

References 12 publications

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“…Frontal impact of increasing severity was applied to the lower vertebra until BFD was achieved. The present macroscopic ligament injuries documented after each impact (Table 1) are consistent with those sustained in real-life BFD [8,29], with the most injuries occurring to the ligamentum flavum and interspinous and supraspinous ligaments. The sagittal motion peaks were consistent chronologically among specimens, however the chronology of the non-sagittal motion peaks was specimen-specific.…”

Section: Discussionsupporting

confidence: 76%

“…Controversy exists regarding the specific ligaments injured [29]. Carrino et al [8] performed a retrospective MRI study of 30 individuals who had sustained BFD, and reported ligament injury rates of 97% for the interspinous and supraspinous ligaments, 90% for the ligamentum flavum and disc, and 40% for the posterior and 26.7% for the anterior longitudinal ligaments. Despite the high injury severity, no clear treatment guidelines exist and the timing of closed reduction remains debatable.…”

Section: Introductionmentioning

confidence: 99%

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Cervical facet joint kinematics during bilateral facet dislocation

et al. 2007

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Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet surface along the lower), separation and compression (displacement of upper facet away from and towards the lower), and lateral shear were determined at the anterior and posterior edges of the right and left facets and statistically compared (P < 0.05). First, peak facet separation occurred, and was significantly greater at the left posterior facet edge, as compared to the anterior edges. Next, peak flexion rotation and anterior facet sliding occurred, followed by peak facet compression. The highest average facet translation peaks were 22.0 mm for anterior sliding, 7.9 mm for separation, 9.9 mm for compression and 3.6 mm for lateral shear. The highest average rotation of 63°occurred in flexion, significantly greater than all other directions. These events occurred, on average, within 0.29 s following impact. During BFD, the main sagittal motions included facet separation, flexion rotation, anterior sliding, followed by compression, however, non-sagittal motions also existed. These motions indicated that unilateral dislocation may precede bilateral dislocation.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Cervical facet joint kinematics during bilateral facet dislocation

et al. 2007

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“…[25][26][27][28] In several studies, MR imaging was also sensitive for the evaluation of injury of the posterior ligamentous complex 19,24 ; this suggests that injury to ALL may be underestimated with the use of MR imaging, if the findings are considered in isolation. The explanation is that ALL and PLL adhere to the disk, whereas only the ALL adheres to the vertebrae, such that the PLL is easier to identify.…”

Section: 24mentioning

confidence: 99%

Spinal Cord Injury after Blunt Cervical Spine Trauma: Correlation of Soft-Tissue Damage and Extension of Lesion

Martínez-Pérez¹,

Paredes²,

Cepeda³

et al. 2013

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length.

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“…Flexion with superimposed distraction vector results in disruption of the posterior ligaments [65] . In cases of complete disruption of facet joint capsular ligaments, bilateral dislocation of the facet joints may occur.…”

Section: Facet Dislocationmentioning

confidence: 99%