Presentation
Head and neck injury during a backflip. No neurological symptoms. Mild pain in the neck.
Patient Data
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.
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.
Rupture of posterior ligamentous complex: interespinous ligament, supraespinous ligament and flavum ligamentum at C5-C6 level (STIR sequence).
No cord edema. No epidural collection.
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.