![]() ![]() It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, or tethered spinal cord syndrome. The condition can cause neural injury and compression of nearby structures, including the brain stem, spinal cord, vagus nerve, and vertebral artery, resulting in a constellation of symptoms.Ĭraniocervical instability is more common in people with a connective tissue disease, including Ehlers-Danlos syndromes, osteogenesis imperfecta, and rheumatoid arthritis. They are considered less severe and often managed conservatively 1.Medical condition affecting the cervical spineĬraniocervical instability ( CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2. C2), and have no associated posterior translocation of the posterior vertebral body. A similar-appearing anteroinferior fracture fragment may occur in extension teardrop fracture however, the extension fractures more commonly occur in the upper cervical spine (e.g. The "teardrop" fracture appearance is non-specific. Although milder cord injuries may be asymptomatic or have few neurological sequelae, injury with posterior column translocation, in particular, is associated with paralysis and quadriplegia 1. The long-term prognosis of this injury mostly depends on the degree of neurological injury. Due to the associated injury of both osseous and ligamentous structures, this fracture is usually unstable with almost all patients requiring decompression and internal fixation. The treatment and prognosis of flexion teardrop fractures are variable and depends on the degree of injury. NB: the interspinous interval may be normal or even decreased following traction-immobilization.evidence of posterior ligamentous rupture.retropulsion of bone fragments which narrow spinal canal.strongly correlates with degree of neurological injury 1,2.degree of posterior translocation of lower vs upper spinal column at the level of injury.The following should receive comment, whether present or absent: Given the spectrum of injury that occurs with flexion teardrop fracture, it is less important to label the findings as "flexion teardrop" and more important to draw attention to clinically relevant information. 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:. ![]()
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