Cervical spine posterior ligamentous complex rupture

Case contributed by Dr Anthony Nuñez

Presentation

Head and neck injury during a backflip. No neurological symptoms. Mild pain in the neck.

Patient Data

Age: 20 years
Gender: Female

Transoral: Atlanto-axial articular space is symetric. No displacement of C1 lateral masses.

Frontal: Height of vertebral bodies is intact. No scoliosis. 

Lateral: Cervical lordosis rectification. Widened interspinous space at C5-6. Subtle narrowing of the disc space at the C5-6-level in the anterior region. Subtle facet joint subluxation C5-C6. 

CT

Cervical spine

Cervical lordosis lost. Widened interspinous space at C5-6. Subtle narrowing of the disc space at the C5-6-level in the anterior region. Better visualization of the facet joint subluxation bilaterally.

No fracture. No epidural hematoma seen on CT. 

MRI

Cervical spine

Rupture of posterior ligamentous complex: interespinous ligament, supraespinous ligament and flavum ligamentum at C5-C6 level (STIR sequence). 

No cord edema. No epidural collection.

X-ray

Cervical spine

Follow up: osteofixation devices at C5-C6 in order to prevent kyphosis. 

Case Discussion

Posterior ligamentous complex rupture associated with facet subluxation typical of a hyperflexion injury. No cord edema in this patient. No symptoms after injury. Osteofixation devices are necessary in order to prevent kyphosis and collapse. 

PlayAdd to Share

Case information

rID: 63486
Published: 5th Oct 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: University Institute CEMIC

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.