Cervical Spine Trauma 09 - Clinical Case Summary
Cervical Spine Trauma 09 - Clinical Case Summary
Cervical Spine Trauma 09 - Clinical Case Summary
SummaryHistory
56 yo female fell off ladder approximately 12 feet
Exams Performed
Cervical spine plain film; Cervical spine CT; Cervical spine MR
Prior available imaging reports
Plain film cervical radiograph
1. There is a rotary injury to C2 vertebral body splitting the C2 body into two sections. One section is subluxed anteriorly, while the other remains in expedected position. The fracture complex is considered unstable.
Cervical CT
1. There is a rotary spiral fracture present which splits the C2 body into two portions. The left portion is subluxed anteriorly and significantly rotated such that the broken left pars intermedia projects into the left part of the spinal canal with putting the spinal cord at traumatic risk.
2. There is a nondisplaced superior end-plate C3 compression fracture (likely an axial loading injury)
Cervical spine MR
1. There is a rotary spiral fracture splitting of the C2 body into two portions. The left portion is subluxed anteriorly and significantly rotated such that the broken left pars intermedia projects into the left part of the spinal canal. However, the canal has enough size for the cervical cord to pass without deformity. The spinal cord signal is normal.
2. There is a developmentally dominant left vertebral artery and a hypoplastic right vertebral artery. Neither appear to have been dissected nor occluded. The right vertebral artery demonstrates signal change from slowed flow in the region of the fractured C2 foramen transversarium.
1. There is a rotary injury to C2 vertebral body splitting the C2 body into two sections. One section is subluxed anteriorly, while the other remains in expedected position. The fracture complex is considered unstable.
Cervical CT
1. There is a rotary spiral fracture present which splits the C2 body into two portions. The left portion is subluxed anteriorly and significantly rotated such that the broken left pars intermedia projects into the left part of the spinal canal with putting the spinal cord at traumatic risk.
2. There is a nondisplaced superior end-plate C3 compression fracture (likely an axial loading injury)
Cervical spine MR
1. There is a rotary spiral fracture splitting of the C2 body into two portions. The left portion is subluxed anteriorly and significantly rotated such that the broken left pars intermedia projects into the left part of the spinal canal. However, the canal has enough size for the cervical cord to pass without deformity. The spinal cord signal is normal.
2. There is a developmentally dominant left vertebral artery and a hypoplastic right vertebral artery. Neither appear to have been dissected nor occluded. The right vertebral artery demonstrates signal change from slowed flow in the region of the fractured C2 foramen transversarium.
Lessons to be Learned
1. Finding consistent with predominantly a rotary injury to C2.
2. There is evidence of a superior end-plate fracture of C3 suggesting that there was some axial-loading related to the fall.
3. There is altered flow rate in the area of foramen transversarium fracture on the right but not the left. Both vertebral arteries have normal flow rates in their high cervical and intradural segments.
2. There is evidence of a superior end-plate fracture of C3 suggesting that there was some axial-loading related to the fall.
3. There is altered flow rate in the area of foramen transversarium fracture on the right but not the left. Both vertebral arteries have normal flow rates in their high cervical and intradural segments.