Traumatic spinal cord injury

Case contributed by Dr Salma Babikir Ahmed Erabi

Presentation

Road traffic accident.

Patient Data

Age: 50 years
Gender: Female
CT

There are multiple cervical spine fractures as follows:

At C2 vertebra: there is bilateral fractures involving the left lamina and right pedicle including the right foramina transversarium.

At C3 vertebra: there is a vertical fracture line involving the body and both right and left laminae.

At C4 vertebra: there is comminuted fracture involving the body, both right and left laminae, and left pedicle including left foramina transversarium, with a widening of right C4/C5 facet joint suggesting facet capsular disruption, as well as distracted facet joint in the left side, giving perched facet joint.

There is retrolisthesis of C4 over C5 vertebra causing severe spinal canal stenosis at this level.

MRI

There is severe spinal cord compression with swelling and edema (hyperintense signal in T2WI) extending from lower C2 down to mid C6 representing cord contusion.

There is bone marrow edema involving C2, C3, and C4 secondary to fractures described above in CT images.

There is edema in the posterior soft tissues of the neck.

Case Discussion

The patient presented with quadriplegia. This case shows severe cervical spinal cord injury secondary to fractures with retropulsion fragments causing severe cord compression.

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Case information

rID: 67050
Published: 21st Mar 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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