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Joseph Junewick, MD FACR
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C5 Hyperflexion Teardrop

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 11 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: CT
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Teenager found flaccid after fall of 30 feet from tree.

Case Images


C5 Hyperflexion Teardrop


CT – Sagittal reconstructed image shows reversal of lordosis, anterior translation of C4 relative to C5, anterior wedging of C5 vertebral body and mild fanning of the spinous processes. Axial images show the sagittal fracture line in the vertebral body and right pedicolaminar fractures with involvement of the vertebral artery foramen.


Hyperflexion teardrop fracture represents a significant injury. Posterior distraction leads to disruption of the posterior ligamentous complex (fanning of the posterior elements, reversal of lordosis and facet dislocation/subluxation), anterior and posterior longitudinal ligaments disruption and intervertebral annulus/disc injury. Anterior cord syndrome (immediate quadriplegia and loss of pain touch and temperature sensations, but with preserved proprioception and vibration sensation) is very common.


Harris JH and Mirvis SE. The radiology of acute cervical spine trauma, 3rd Ed. Williams and Wilkins (1996).

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