Presentation
Car accident. Concern for cord injury. (Hot Read)
Patient Data
Unstable C3-4 injury including acute tear of the PLL / posterior disc annulus, rupture of the ligamentum flavum, interspinous ligament tear with widened interspinous distance, and right facet joint capsular disruption. There is a large predominately left anterior epidural fluid collection extending inferiorly into the upper thoracic spine. The epidural fluid causes complete effacement of CSF and distortion of the cord maximal at C5-6 where there is associated ill-defined high T2 signal within the cord consistent with edema. The epidural fluid collection matches CSF signal even on T1 and therefore may represent CSF leak into the epidural space rather than hematoma.
Case Discussion
Unstable discoligamentous injury at C3-4 with associated epidural fluid collection maximal from C5 to C6 where there is cord edema.
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