Presentation
Head trauma and severe neck pain. No other symptoms.
Patient Data
Urgent head and cervical CT
Head CT
minimal frontal subcutaneous contusion
head CT is otherwise unremarkable
Cervical spine CT
C6 vertebral body anterior translation over C7 of up to 6 mm. Associates C6 left axial rotation
loss of normal cervical lordosis due to anterior C6 angulation
right C6-C7 facet dislocation. Left C6-C7 facet subluxation
C7 superior platform wedge compression fracture
Urgent cervical MRI
C6 vertebral body anterior translation over C7 of up to 6 mm, associated C6 left axial rotation
right C6-C7 facet dislocation; left C6-C7 facet subluxation
D1, D2, and D3 superior platforms edema, subtle hypointense parallel lines, and slight deformity of the anterior walls, suggestive of wedge compression fractures
ligamenta flava disruption at C6-C7 and C7-T1
C2 to T1 interspinous edema due to interspinous and nuchal ligamentous lesion, without clear nuchal ligament disruption
bilateral paravertebral musculature edema
vertebral canal stenosis at C6-C7 with anterior subarachnoid space obliteration; slight spinal cord deformity without evident cord hyperintensity on axial images (Gibbs artifact on sagittal STIR)
Case Discussion
The patient presented to the emergency department after jumping into the sea and sustaining a blow to his head with cervical hyperflexion. The neurological examination was normal.
The injury can be summarized as a translation-rotation C6-C7 injury with bilateral facet dislocation, injury to the posterior longitudinal ligament, and C7, T1, T2 and T3 compression fractures, without evidence of compressive myelopathy. He was referred for urgent surgery to reduce and stabilize his spine.
According to the AOSpine classification system for subaxial cervical and thoracolumbar spine injuries, it corresponds to: C6-C7: C (F4 BL) (C6-C7: B2, C7: A1), N0.
Associated injuries: T1: A1, T2: A1, T3: A1.
Unable to process the form. Check for errors and try again.