Findings
- Severe (approximately 1.5 cm) anterolisthesis of C6 on C7 with bilateral jumped C6-C7 facet joints
- Mildly displaced avulsion fracture of the left C5 transverse process posterior tubercle
- C6 spinous process fracture with surrounding tiny fracture fragments
- Minimally displaced avulsion fracture from the superior ventral margin of the C7 vertebral body
- Multiple small avulsion fractures associated with the C6 inferior and C7 superior articulating facets
- Widening of the epidural space ventrally at C5-C6 consistent with a small epidural hematoma
- Left posterior first and second rib fractures
- Biapical pulmonary contusion and small pneumothoraces
- Extensive prevertebral edema
Diagnosis
Severe traumatic malalignment with jumped facets
Sample Report
Severe traumatic malalignment at C5-C6 with 1.5 cm anterolisthesis and bilateral jumped facets. This malalignment in combination with a thin ventral epidural hematoma results in severe spinal canal compromise concerning for severe cord injury or transection. Noncontrast cervical spine MRI could further assess the degree of ligamentous injury and assess the cord.
Multiple small associated avulsion fractures including left C5 transverse process, C6 spinous process, and bilateral tiny C6 and C7 facet fractures.
Given the above described malalignment, neck CTA is recommended to assess for vascular injury.
Left posterior first and second rib fractures with biapical pulmonary contusions and small bilateral pneumothoraces.
Discussion