Table 6 CT fingerprints and injury vectors
From: MDCT of acute subaxial cervical spine trauma: a mechanism-based approach
Biomechanics | Anterior fingerprints | Posterior fingerprints |
|---|---|---|
Hyperflexion | Anterior column compression | Posterior column distraction |
Curvature: focal kyphosis Alignment: anterolisthesis VB: wedge compression and flexion teardrop. Burst/coronal split: axial loading Disc space: focal posterior widening or diffuse narrowing. | Facet joint: diffuse widening more than 2 mm, focal posterior widening, subluxation and dislocation Interspinous widening | |
Hyperextension | Anterior column distraction | Posterior column compression |
Curvature: hyperlordosis or normal Alignment: normal or retrolisthesis VB: extension teardrop Disc space: focal anterior widening/normal | Articular pillar/process fracture Lamina/spinous process fracture Pediculo-laminar separation | |
Lateral flexion | Always coupled with rotation. Frequently associated with hyperextension and hyperflexion. Reciprocal compressive and distractive injury on right/left side Curvature: coronal plane tilt VB: lateral compression injury on the side of flexion Asymmetrical loss of disc height in coronal plane | Reciprocal compressive and distractive injury on right/left side Unilateral articular pillar or laminar fracture. Facet joint distraction on the side opposite of posterior element fracture |
Rotation | Usually associated with flexion, extension | Unilateral facet dislocation or fracture Asymmetric posterior column injury |