Table 1 Cervical spine trauma CT interpretation: checklist
From: MDCT of acute subaxial cervical spine trauma: a mechanism-based approach
Anterior column | Posterior column | |
|---|---|---|
Bone | Vertebral body: | Neural arch: |
Normal—preserved height without wedging, smooth cortices without step Abnormal—fracture Further description—comminution, Involvement of posterior cortex of vertebral body, retropulsion of fragments | Normal—intact without fracture Abnormal—fracture Further description: comminution, Orientation of fracture line—vertical vs horizontal; unilateral vs bilateral; symmetrical vs asymmetrical; isolated posterior elements or associated with anterior column fractures | |
Joints | Intervertebral disc: | Facet joint: |
Normal—symmetrical disc space without focal widening or narrowing Abnormal—focal anterior or posterior widening or asymmetry in coronal plane | Normal—congruent, parallel and symmetrical Abnormal—diastasis, subluxation, dislocation; focal anterior vs posterior widening Further description—unilateral vs bilateral Associated articular process fracture | |
Ligaments | ALL/PLL: | PLC: |
Normal integrity inferred from alignment of anterior posterior vertebral lines Abnormal—anterior vs posterior translation. Triangular avulsion at the corners of vertebral end plates | Normal- Integrity inferred from the normal alignment, interspinous distance and facet joint morphology Abnormal—Anterolisthesis, focal kyphosis, interspinous widening and facet joint abnormality as mention in the previous column | |
Curvature | Normal—smooth lordosis Abnormal—focal kyphosis | – |
Alignment | Anterior/posterior vertebral body lines in sagittal plane | Spinolaminar and interspinous lines on sagittal plane Interspinous and articular pillar lines in coronal plane |
Measurement | – | Interpedicular distance. Interspinous and interlaminar distance Abnormal: difference of more than 2 mm |