C6-7 fracture-dislocation

Case contributed by Dr Ahmed Almuslim

Presentation

High speed RTC. Restrained driver. LOC at scene.

Patient Data

Age: 50 years
Gender: Male
X-ray

Never report a spinal x-ray as normal when you dont see the entire cervical spine from C1 to the upper part of T1

CT

C6/7 dislocation with associated fracture and bilateral dislocated facets.

MRI

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.

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