Presentation
Quadriparesis following trauma.
Patient Data
There is reversal of the normal cervical lordosis with maximal curvature at C4/C5 vertebral levels. There are compression fractures involving C4 and C5 vertebrae with reduction in their body heights, near obliteration of the adjoining disc space and disruption of the anterior longitudinal ligament. A wedged shaped fractured segment involving the posterior vertebral body of C4 is also noted. There is associated retropulsion of C4/C5 vertebral bodies and the fractured bone fragment into the spinal canal causing significant compression and buckling of the cervical cord. The spinal cord is swollen and appears hyperintense on T2/STIR spanning from C2 to C7 indicative of cord edema.
Prevertebral soft tissue is widened suggesting acute inflammatory changes. The posterior soft tissues also show inflammatory changes.
Case Discussion
Traumatic spinal cord injury may result from trauma to the spine which may fracture, compress, or dislocate one or more vertebrae causing direct injury to the spinal cord. Symptoms depend on the region of the spinal cord affected and the severity of the injury. This patient presented with quadriparesis following a traumatic cervical spine injury. MRI findings are consistent with cervical cord injury with associated cord edema.
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