C • DISLOCATIONS OF THE VERTEBRAL COLUMN
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fracture-dislocation may be stretched upwards in a diagonal direction. Therefore, it
would be more accurate to use the terms retro-hyperflexion and ventro-hyperflexion
for these two types of spinal injuries.
In a lesser degree of violence in ventro-hyperflexion, the resulting deformity of the
spine may be a dislocation in ventro-hyperflexion only.
Vertical stress to the vertebral column, as a result of a fall on the head or seat or neck,
may produce a compression fracture with flattening of a whole vertebral body without
rupturing the ligamentous complex, but the compressed vertebral body will protrude
into the transverse plane anteriorly and/or posteriorly, resulting in more or less destruc–
tion of the cord.
Various other factors have to be considered to understand the great varieties of spinal
injury.
(l) CONGENITAL ANOMALIES OF THE SPINE
Congenital and acquired anomalies may influence type, extent and severity of spinal
injuries. Congenital anomalies occur in particular in the most proximal (atlanto-axial)
and distal (lumbo-sacral) parts of the spine. In the atlanto-axial region, fusion of the
atlas to the occiput (atlanto-occipital assimilation) may be combined with platybasia and
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60
FIG. 41.
