Presentation
Fall in shower at home with headstrike. Weakness bilateral upper limbs (distal more than proximal) and hyperreflexia.
Patient Data
No fracture or malalignment. No prevertebral soft tissue swelling. Posterior osteophytes and posterior longitudinal ligament ossification at the level of C5 results in severe canal stenosis.
Marked central canal stenosis at C5 and C6 secondary to OPLL. There is severe cord compression with high T2 signal from C4/5 to C6. No cord hemorrhage
High T2 signal is also demonstrated within the interspinous ligaments particularly at C4/5, C5/6 and C6/7, with a small amount of abnormal T2 signal also seen in the prevertebral soft tissues. No fractures or convincing disc injury is evident. The anterior longitudinal ligament, ligamentum flavum, and supraspinous ligament/nuchal ligament appear intact.
Case Discussion
The MRI findings are consistent with a hyperextension injury and accounts for the patient's central cord syndrome.
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