Cervical spine fracture with dislocation

High-speed car accidentFall from height (4th floor) with collapse and lost consciousness.

Fracture dislocation at C7/D1 with bilateral facetal dislocated (jumped facets) as well as marked anterolisthesis (grade IV) with subsequently compromised spinal canal at this level and spinal cord compression evident by segmental cord abnormal signal (myelopathy), elicits high signal in T2. No evidence of complete cord transection nor disruption of its continuity on axial images.

Injured posterior longitudinal ligament opposite this level with further kink and intra-substance bright heterogeneous signal.

Small anterior epidural thickening with signal alteration (hematoma).

C7-D1 disc appears pseudo bulged anteriorly with prominent annular bulge and stretching and probable annular fissures or rupture.

Prevertebral / retropharyngeal edema is seen at the injury site. Paraspinal soft tissue edema is also noted more prominent posteriorly at the upper cervical region.

Incidental C5-6 posterior central foal disc protrusion is seen mildly indenting the ventral cord.