Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Anterior Fontanelle Dermoid
Joseph Junewick, MD FACR
over 6 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Hyperflexion Teardrop Injury

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
Adobe32 PDF Imagej32 ImageJA

History

13 year old found flaccid after fall of 30 feet from tree.


Case Images


Diagnosis

Hyperflexion Teardrop Injury

Findings

CT – Sagittal recontructed image shows reversal of cervical lordosis, anterior translation of C4 relative to C5, anterior wedging of the C5 vertebral body and mild fanning of the posterior elements. Axial images demonstrate the sagittal vertebral body fracture and right pedicolaminar fractures with involvement of the vertebral artery foramen.

Discussion

Burst fractures and hyperflexion teardrop fractures are likely variations of the same injury.

A burst fracture results in comminution of the vertebral body with the predominant fracture line in the sagittal plane and retropulsion of the posterior-superior corner into the spinal canal. Fractures of the posterior elements are also invariably present. Cervical lordosis is straightened but not reversed. Cord injury is variable depending upon the degree of canal compromise by the retropulsed fragment.

Hyperflexion teardrop fractures are associated with posterior distraction and consequently fanning of the posterior elements and reversal of cervical lordosis. Hyperflexion teardrop injuries are associated with acute anterior cord syndrome (immediate quadriplegia, loss of pain, and loss of temperature and touch sensations but preserved proprioception and vibration sensation). The anterior and posterior longitudinal ligaments and intervertebral disc are disrupted. The distraction of the posterior elements tears the posterior ligament complex leading to subluxation or dislocation of the facets.

Reference

Harris JH and Mirvis SE. The Radiology of Acute Cervical Spine Trauma, 3rd Ed (1996).



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare