Presentation
Push bike accident.
Patient Data
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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