Presentation
High speed RTC. Restrained driver. LOC at scene.
Patient Data
Never report a spinal x-ray as normal when you dont see the entire cervical spine from C1 to the upper part of T1
C6/7 dislocation with associated fracture and bilateral dislocated facets.
Associated cord injury at C6/7 with loss of signal centrally, associated edema and widening of the cord. Associated edema in the posterior ligaments following hyperflexion.
Case Discussion
This man was involved in a high speed motor accident.
His initial cross-table lateral C-spine x-ray demonstrates normal alignment of the upper cervical spine with no pre-vertebral soft tissue swelling.
This case highlights the importance of always needing to see the whole of the cerical spine and the top of T1 because there is a huge injury at C7 with fracture/dislocation and bilateral facet dislocation. The subsequent MRI demonstraes the associated cord injury.