Traumatic spinal cord injury

Case contributed by Frank Gaillard
Diagnosis certain


Push bike accident.

Patient Data

Age: 30 years

Comminuted fracture of C5 vertebral body with up to 7 mm of retropulsion causing severe central canal stenosis. Posteriorly, there are fractures of bilateral laminae. There is mild paravertebral soft tissue hematoma this level. There is subluxation of facet joint of C5/C6 bilaterally.


Unstable three column burst fracture of C5 with 7 mm of retropulsion into the canal and posterior widening of the C5/6 facet joints. The spinal cord is compressed with edema and central signal loss consistent with hemorrhagic contusion. 

PLL is intact posterior to C4/5, but partially torn at C5/6.

ALL is partially torn anterior to C5 with pre-vertebral high signal extending

Vertebral arteries are capacious with normal flow voids.

Normal atlanto-axial and atlanto -occipital alignment and joints with intact tectorial membrane and cruciate ligaments.

Case Discussion

Presence of cord hemorrhage is a poor prognostic sign in the setting of spinal cord injury. 

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