Post traumatic ligamentum flavum tear

Case contributed by Dr Andrew Lawson

Presentation

Motorcar accident.

Patient Data

Age: 25 years
Gender: Male

Anterior crush fracture T1.

The fracture through the T1 vertebral body with marrow edema is again noted with less than 20% loss of vertebral body height. The adjacent intervertebral discs are normal. The anterior longitudinal and posterior longitudinal ligaments are intact. Diffuse T2 signal abnormality between the spinous processes of C7-T1 extends deep to the level of the ligamentum flavum where is a focal disruption of the ligamentum flavum, with 8mm widening. The facet joints are enlocated. Small effusions at the lateral atlanto-axial joints and a some of the mid cervical facet joints. STIR signal abnormality is demonstrated along the superior endplates of C7, T2, T3 and T4, with a subtle fracture line and superior endplate collapse at T3 and T4 consistent with microtrabecular impaction fractures. No epidural haematoma.

Extensive prominent soft tissue oedema noted in the posterior cervical paraspinal muscles from C2 to T4-5. The visualised posterior fossa content is unremarkable.

Conclusion: 1. T1 vertebral body anterior wedge compression fracture with focal disruption of the ligamentum flavum and tear of the interspinous ligaments between C7-T1. 2. Multiple superior end-plate microtrabecular fractures of C7, T2, T3 and T4.

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Case information

rID: 27148
Case created: 22nd Jan 2014
Last edited: 21st Jul 2017
Inclusion in quiz mode: Included

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