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Heather Borders, MD
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Cord Injury - Hyperflexion Teardrop

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

13 year old found flaccid after falling 30 feet from tree.


Case Images


Diagnosis

Cord Injury related to hyperflexion teardrop fracture

Findings

MR – Anterior translation of C4 relative to C5, anterior wedging of C5, fanning of the spinous processes, and reversal of cervical lordosis consistent with hyperflexion teardrop injury. The ALL, PLL and posterior ligamentous complex are disrupted. Note the multilevel cord edema.

Discussion

Hyperflexion teardrop fractures are associated with anterior cord syndrome (immediate quadriplegia and loss of pain temperature and touch sensations but preserved proprioception and vibration). Cord edema has better prognosis than cord hemorrhage. Short segment involvement portends a better prognosis than long or multiple segment involvement.

Reference

Kim KS, Chen HS, Russell EJ, Rogers LF. Flexion teardrop fracture of the cervical spine: Radiographic characteristics. AJR (1989); 152:319-326.



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