Cervical Spine Trauma CT
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0893-Cervical Spine Trauma CT
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CA0893-Cervical Spine Trauma CT
Case ReportHistory
Exam
Prior Study
Findings
Cervical spine CT
There is extensive age-related cervical spondylosis. There are articular pillar bridging osteophytes producing autofusion at C3-5. There are disc margin bridging osteophytes producing autofusion at C3-6. The only available functional motion segments occur in the C2-3 and the C7-T1 levels. There abnormal increased C1-2 motion has resulted in a chronic nonunion of a prior type-2 dens fracture and erosive osteoarthritis of the left C1-2 articular joint. There is evidence of posterior protrusion of a disc at C3-4 and C3-5 with some degree of canal narrowing (residual sagittal width measures 9 mms; the residual canal width is better evaluated with MR. There is foraminal compression by osteophtes evident at C7-T1 and T1-2 (worse on the left).
There is a type 2 dens fracture. However, the fracture margins are both densely sclerotic and irregular consistent with a chronic nonunion of a prior traumatic event. There is a 2 mm posterolisthesis of the dens relative to the C2 body, but the canal width is well maintained. There is thickening of the tectorial membrane posterior to the dens consistent with chronic reparative fibrosis. No flexion-extension plain films are available to assess any current additional instability.
There is an unsuspected axial-loaded compression fracture of the superior end-plate of T2. This is only detected on the axial imaging. However, the fracture margins are not sharp and not seen in any plane other than the axial. Thus, this fracture is considered chronic and healed.
There is extensive chronic scarring the upper lung zones bilaterally, presumably from prior TBc or other granulation disorder.
Other
No other abnormalities are present other than cervical trauma.
Impression
2. There is cervical restricted motion from C3 to C7 due to age-related spondylosis. The spinal canal sagittal width in this area measures 9 mms.
3. There is foraminal constriction at C7-T1 and T1-2 mainly on the left related to bone osteophytes.
4. There is widening of the anterior disc width at C2-3 and C7-T1. But, whether this is a chronic effect from spinal leveraging or is in part related to acute disc injury is indeterminate; correlate with MR.
Recommendations
No recommendation
