C6 compression fracture with posterior spinal fractures and cord contusion
Presentation
Pedestrian struck in MVC. Neck pain. Significant immediate motor deficit with left arm flexion and complete left leg paralysis. Weak right limbs. Right leg pain sensation lost and midthoracic sensory level. Fecal incontinence.
Patient Data
Immobilized in trauma collar.
High STIR signal in the C6 vertebra with loss of vertebral body height in keeping with the known compression fracture with sagittal fracture cleft. There is minor anterior narrowing of the spinal canal at this level but canal remains capacious with no cord compression. The cord is expanded at this level with T2 hyperintensity extending craniocaudally over 19 mm.
The patient was managed with halo immobilization. Persisting incomplete tetraparesis.
One mth FU following halo...
One mth FU following halo immobilization.
Reduced height of C6 vertebral body, with healed posterior elements.
Myelomalacia of the cord at C6, predominantly left and dorsal cord affected.
Case Discussion
Access to urgent MRI for cervical spine injuries with neurological deficits is an essential part of spinal care. This case demonstrated contusions at the C6 fracture level (with associated posterior element fractures at other levels), with maturation to myelomalacia on follow up imaging.
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