Presentation
Motor vehicle accident suspected cervical spine fracture and no neural deficits.
Patient Data
Age: 30 years
Gender: Male
From the case:
Cervical extension-teardrop fracture
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CT showed displaced anteroinferior bony fragment of C2 and fractured spinous processes C5, C6 and C7.
From the case:
Cervical extension-teardrop fracture
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- MRI confirms extension-teardrop fracture of C2, the displaced anteroinferior bony fragment. This fragment is a true avulsion fracture since the soft tissue swelling injury is located anteriorly in the prevertebral as well as torn ALL at C2/C3, C4/C5, and C6/C7
- there is a subtle widening of the disc space C2-C3, C3-C4, C5-C6, and C6-C7 in the front and narrow in the back
- fracture of the spinous processes of C5, C6, and C7 and decreased interspinous distance, T2 and STIR images to demonstrate marrow edema within the spinous process as well as injury to the interspinous and supraspinous ligaments
- the facet joints are normal
- normal appearance of the craniocervical junction
- no abnormal signal intensity of the imaged parts of the spinal cord
Case Discussion
This case is a good example of an extension teardrop fracture and demonstrates some subtle findings as demonstrated in the case findings.
This fracture is a true avulsion fracture and occurs when the anterior longitudinal ligament pulls the inferior aspect of the vertebra, because of the sudden hyperextension. In contrast to the flexion teardrop fracture is produced by compression fracture because of hyperflexion.
This injury is unstable in extension movement.