Cervical Spine Trauma 04 - Clinical Case Summary
Cervical Spine Trauma 04 - Clinical Case Summary
Cervical Spine Trauma 04 - Clinical Case Summary
SummaryHistory
37 yo female. High speed MVC rollover
Exams Performed
Cervical spine plain film; Cervical spine CT
Prior available imaging reports
Plain film cervical radiograph
1. Focal, abnormal rotary subluxation and 2 mm anterolisthesis is evident at C6-7 motion segment. Unilateral articular pillar injury is likely, but is not definitive on the plain film; CT evaluation is recommended. There is no evidence that this injury is unstable.
Cervical spine CT
1. There is a right C6 articular pillar body compression fracture and possible C5 osteophyte avulsion fracture. There is no foraminal compromise nor spinal canal involvement.
2. The fracture of the right C5 inferior articular process has minimal dorsal fragment displacement.
3. The findings are consistent with either a hyperextension or a lateroflexion mechanism; this injury complex is not likely to be unstable
Cervical spine MR was not obtained
1. Focal, abnormal rotary subluxation and 2 mm anterolisthesis is evident at C6-7 motion segment. Unilateral articular pillar injury is likely, but is not definitive on the plain film; CT evaluation is recommended. There is no evidence that this injury is unstable.
Cervical spine CT
1. There is a right C6 articular pillar body compression fracture and possible C5 osteophyte avulsion fracture. There is no foraminal compromise nor spinal canal involvement.
2. The fracture of the right C5 inferior articular process has minimal dorsal fragment displacement.
3. The findings are consistent with either a hyperextension or a lateroflexion mechanism; this injury complex is not likely to be unstable
Cervical spine MR was not obtained
Lessons to be Learned
The type of articular pillar fracture is helpful in deciding between a hyperextension or lateral compressive fracture versus a rotational or hyperflexsion injury vector. The lateroflexion or hyperextension injuries cause a crush fracture of the mid body portion of the articular pillar. The hyperflexion and rotary injuries result in articular process fractures usually sparing the mid articular body.