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- the spinous processess of the C5-6 vertebra show hairline fractures without displacement, which is best seen in the sagittal plane. We should look for further injuries along these segments.
- the left pedicle and both tranvserse processes of C6 also show undisplaced fractures.
- in keeping with this, the flowing osteophytes show an abrupt break anteriorly between C5 and C6, while a discrete fracture line extends to the superior endplate of C6 too.
- since the (calcified) anterior longitudinal ligament is also injured resultant soft tissue injury, namely prevertebral hematoma should be scrutinised. Indeed there is an about 30 mm long, 5 mm thick soft tissue density collection anteriorly, in keeping with hematoma.
- careful assessment of the facet joints also reveal a right C5-6 subluxation.
Altogether the observed findings make this an unstable complex fracture involving all three columns of the spine.
Head CT was unremarkable considering the age group and showed no acute bony or brain injury or other significant pathology (not shown).