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Chiari III
Joseph Junewick, MD FACR
over 10 years ago
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Hyperextension Distraction Injury of Thoracic Spine

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 9 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: CT MR
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3 year old female involved in motor vehicle accident.

Case Images


Hyperextension Distraction Injury of Thoracic Spine


CT – 1) Transverse splitting of T3 posterior elements extending into the superior vertebral body, 2) Hyperextension teardrop fracture of T2, 3) Extensive craniocervical injury (precervical edema and hemorrhage, widened anterior atlanto-axial space, elevation of the tectorial membrane, cervicomedullary edema, and suboccipital edema).


Distraction injuries typically occur at junctional zones (occipito-cervical, cervico-thoracic and thoraco-lumbar junctions). Thoracic distraction injuries between T2 and T10 (non-junctional) are very rare but may be explained by fulcrums applied to the anterior chest (e.g., restraint belts, steering wheels) or posterior chest (e.g., fall upon fixed object). With vertical distraction, the spinal column splits transversely; the split may involve the bone, disks, ligaments, or a combination of bone and soft-tissue disruption.


Backstrom JW, Junewick JJ. Vertebral Trauma, in Caffey’s Pediatric Diagnostic Imaging, 11th Ed (2008).

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