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Best Practice Case Studies
Cervical Spine Fracture
Cervical Spine Fracture
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Video Transcription
This is Barry Belosis, one of the musculoskeletal radiology fellows at Stanford University. 21 year old American football player suffered a cervical spine injury on the field during a competition concerned for cervical spine fracture. This is the patient in this case who underwent CT cervical spine without contrast. In the setting of trauma with concern for cervical spine fracture, CT cervical spine is recommended. Radiographs are not routinely done as they are insensitive with only 47% sensitivity in detecting cervical spine fracture. Here we can see mild anterolesthesis of C4 over C5, and when we move to the lateral side on the left, we can see a perched and fractured C4 facet which is perched on the superior facet of C5. On our axial imaging we can see the left perched facet as seen here with fracture and fracture of the right lamina also demonstrated here. The patient underwent MRI without contrast. In here we can see some disc bulge at C3, C4, and also the anterolesthesis of C4 over C5 with uncovering of the disc at this level. There is also mass effect on the anterior tickle sac and the anterior aspect of the spinal cord at this level. No abnormal cord signal is detected. Additionally, there is an incidental note of a focal syringomyelia at the level of C7 right here. On our sagittal T1 imaging we can again see the perched facet of C4 over C5 and the displaced fracture as we can see here. The other things that we look at is possible epidural hematoma or any kind of abnormal cord signal.
Video Summary
A 21-year-old American football player suffered a cervical spine injury during a game, suspected to be a fracture. A CT was performed, as radiographs are typically insufficient for detecting such fractures. The CT revealed mild anterolisthesis of C4 over C5, with a perched and fractured C4 facet and a fractured right lamina. An MRI showed disc bulge at C3-C4 and mass effect on the spinal cord, but no abnormal cord signal. An incidental syringomyelia at C7 was noted. The perched facet and displaced fracture on T1 imaging were also observed, with no epidural hematoma detected.
Meta Tag
Edition
2nd Edition
Related Case
2nd Edition, CASE 51
Topic
Spine
Keywords
2nd Edition, CASE 51
2nd Edition
Spine
cervical spine injury
anterolisthesis
syringomyelia
CT and MRI findings
American football
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