Editing Spinal injuries (section)

== Anatomy ==

* Three columns - vertebral bodies and posterolateral pedicles 
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** Anterior column: anterior longitudinal ligament, most of vertebral body (ant 2/3), ant fibres of annulus fibrosis and nucleus pulposis
** Middle: posterior cortex of vertebral body and posterior longitudinal lig and post fibres of annulus fibrosis
** Posterior: pedicle, llamina, facet joints, spinous process, interspinous/supraspinous ligaments, ligamentum flavum
** In general, a single-column injury is stable
** A middle column injury usually implies a 2 or 3 column injury, implying instability
** Instability requires two column injury AT THE SAME LEVEL
* Cervical spine most vulnerable to injury - 55% of spinal injuries begin here
* Cervical canal wide from foramen magnum to lower C2 - if patients survive initial injury, likely to be neurologically intact - can also die at the scene from apnoea from phrenic nerve injury
* C3 and below - small spinal canal - likely spinal cord injury
* Children >12yo have fairly similar spines to adults
* Spinal cord - foramen magnum to L1, then cauda equina