Cervical Spine Trauma 12 - Clinical Case Summary
Cervical Spine Trauma 12 - Clinical Case Summary
Cervical Spine Trauma 12 - Clinical Case Summary
SummaryHistory
36 yo male MVC unresponsive on arrival but intoxicated
Exams Performed
Cervical spine CT; Cervical spine MR
Prior available imaging reports
Plain film cervical radiographs were not obtained
Cervical spine CT
1. There is a distractive injury of the C6-7 interlaminar and intraspinous ligaments, suggesting either a hyperflexion or rotary injury mechanism. Other freatures of a hyperflexion injury vector are not present, but other features of a rotary injury are present.
2. There is a left sided crack (partial fracture) in the left C6 pedicle, plus a transverse fracture of the left C6 lamina, plus articular facet injuries to the left C5-6 joint and the C6-7 joints.
3. Findings are consistent with a rotary injury centered at the left C6 level; these injuries are considered stable.
Cervical spine MR
1. There is confirmatory evidence of rotary complex affecting the left C6-7 levels. The left C6 laminar or pedicules fractures are less well seen on MR than CT. MR confirms the articular joint effusions at C5-6 and C6-7. MR provides evidence of focal tear of the spinolaminar ligament at C6-7
2. There is no spinal malalignment, and no spinal canal/spinal foramina/spinal cord injuries.
Cervical spine CT
1. There is a distractive injury of the C6-7 interlaminar and intraspinous ligaments, suggesting either a hyperflexion or rotary injury mechanism. Other freatures of a hyperflexion injury vector are not present, but other features of a rotary injury are present.
2. There is a left sided crack (partial fracture) in the left C6 pedicle, plus a transverse fracture of the left C6 lamina, plus articular facet injuries to the left C5-6 joint and the C6-7 joints.
3. Findings are consistent with a rotary injury centered at the left C6 level; these injuries are considered stable.
Cervical spine MR
1. There is confirmatory evidence of rotary complex affecting the left C6-7 levels. The left C6 laminar or pedicules fractures are less well seen on MR than CT. MR confirms the articular joint effusions at C5-6 and C6-7. MR provides evidence of focal tear of the spinolaminar ligament at C6-7
2. There is no spinal malalignment, and no spinal canal/spinal foramina/spinal cord injuries.
Lessons to be Learned
1. Linear, nondisplaced fractures without substantial bone edema are difficult to see on MR.
