![]() additional spinal fractures at other levels.more common inferior to the posterior vertebral body fragment vs the anterior fragment.intervertebral disc space narrowing ( discoligamentous injury).anterior dislocation of the facet joints.abnormal spinal alignment: often less apparent if imaging occurs after traction is performed. ![]() vertebral body rotation with an AP diameter that appears smaller than on other levels.sagittal fracture through the vertebral body.loss of anterior height of the vertebral body.variable fracture of the vertebral body.posterior displacement of the posterior vertebral body relative to the intact inferior cervical columnĭepending on the fracture severity, additional findings may include:.anterior fragment often minimally displaced.larger fragments may not appear triangular.classically a triangular fragment (teardrop sign).fracture of the anteroinferior lip of vertebral body.The most characteristic findings include: Radiographic featuresįlexion teardrop fractures most commonly occur at the mid/lower cervical spine, specifically at C4, C5, or C6 1,2. Less severe injuries manifest as incomplete patterns, and are less associated with neurological injury 1. The overall extent of injury is quite variable. variable posterior translocation of the lower cervical column in relation to the upper column 1,2, often with focal kyphotic deformity these features, together with possible retropulsed fracture fragments, correspond to the characteristic anterior spinal cord injury.forward rotational force causing distraction along posterior elements and tensile rupture of posterior ligaments (e.g.fracture continuation through the vertebral inferior subchondral plate (endplate), with shearing/rotational injury of the posterior discoligamentous complex and rupture of posterior longitudinal ligament 1.shearing/compression fracture along the anterior vertebral body, isolating a (classically) triangular anterior fragment and with rupture of anterior longitudinal ligament.With the most severe injuries, there is a structural failure in a characteristic pattern: diving impact, deceleration during motor vehicle collision). This allows for discrepancies in the tilt of the head (flexion/extension of the cervical spine).The injury typically occurs from severe flexion and compression forces (e.g. To achieve the best angle, the central ray should be directed at an angle that parallels the plane of the mandible and then directed to just below the hyoid bone. An excessive or insufficient angle can distort these disc spaces. To project the intervertebral disc spaces open, the central ray should be directed perpendicular to the long axis of the vertebral column 3, 4. This angle can and will vary between 5-20° depending on the position of the head. For this reason, a cephalic angle is required to project through the long axis of the vertebral column. Correcting tube angle errors and head tilt errorsĪ lordotic curvature exists in the cervical spine. The spinous process will rotate toward the pedicle of the side farther from the image receptor 3. The spinous process should be midline of the vertebral body, equidistant from both pedicles 3. Any deviation from the midline indicates rotation is present. Rotation can be detected by looking at the spinous processes in relation to the pedicles. make sure that any removable artifacts such as earrings, glasses or metal dentures are removed to avoid obscuring the anatomy of interest.spinous processes should be midline, equidistant to the pedicles, indicating that there is no rotation.cervical spine intervertebral disk spaces should be open 2.superiorly to include C2 and inferiorly to include T2.laterally to include the entire cervical spine.the central ray is midline centered at the level of C4 to enter immediately below the hyoid bone.chin should be raised to align the lower margin of the upper incisors to the mastoid tips/base of the skull (unless trauma when the patient is placed in a cervical collar).patient shoulders should be at equal distances from the image receptor to avoid rotation.patient positioned erect in AP position (unless trauma when the patient will be supine).This projection helps to visualize pathology relating to C3-C7 in the anatomical position, demonstrating any compression fractures, clay-shoveler fractures and herniated nucleus pulposus (HNP) 1.
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