Posterior ligamentous complex injury

Case contributed by Sally Ayesa


Domestic violence incident. Neck pain.

Patient Data

Age: 30 years
Gender: Female

Reversal of the normal cervical lordosis for focal kyphosis centered at approximately C6. Widening of the interspinous distance at C5/C6. Subluxation of the left C5/C6 facet joint. Mild epidural soft tissue thickening posterior to C5/C6. Findings are highly concerning for soft tissue/ligamentous injury of the posterior complex.

No acute fracture.

No significant prevertebral soft tissue thickening/prevertebral hematoma.

Case Discussion

The patient went onto MRI which confirmed the presence of soft tissue/ligamentous injury of the cervical spine at C5/C6, as well as injury to the C5/C6 intervertebral disc. She went on to have an anterior cervical discectomy and fusion to stabilize the injury.

Traumatic ligamentous and soft tissue injuries of the neck often present with an abnormal alignment of the cervical spine, as seen in this case. Posterior ligamentous complex injuries can present as focal kyphosis and splaying of the interspinous distance without associated vertebral body fracture.

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