J Korean Orthop Assoc.  2007 Aug;42(4):433-443. 10.4055/jkoa.2007.42.4.433.

Soft Tissue Damage in Cervical Spine Extension Injury

• Song KJ
• Kim GH
• Wang SI
• Lee JH

• KMID: 2186504
• DOI: http://doi.org/10.4055/jkoa.2007.42.4.433

Abstract

PURPOSE: To diagnose the extent of soft tissue damage with MRI, and to evaluate the relationship between soft tissue damage and a spinal cord injury in an extension injury to the lower cervical spine trauma.
MATERIALS AND METHODS
Eighty-one patients who treated surgically for an anextension injury to the cervical spine over the past 5 years, were analyzed. All patients had undergone MRI after the injury, and for the specific grading of soft tissue damage, the grades were defined from grades 1 to 5.
RESULTS
The spinal cord injury developed with more than grade 3 soft tissue damage associated with a rupture of the posterior longitudinal ligament (p<0.01). The changes in signal intensity of the spinal cord also developed according to the severity of soft tissue damage (p<0.01). There was no relationship between the soft tissue damage and the spinal cord injury in spinal stenosis (p=0.75).
CONCLUSION
The extent of soft tissue damage was diagnosed precisely with MRI, and there was an close relationship between the soft tissue damage and spinal cord injury in the distractive- extension injury to the lower cervical spine trauma.

Keyword

Lower cervical trauma; Distractive-extension injury; Grading of soft tissue damage; Spinal cord injury

MeSH Terms

Humans
Longitudinal Ligaments
Magnetic Resonance Imaging
Rupture
Spinal Cord
Spinal Cord Injuries
Spinal Stenosis
Spine*

Figure

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  Fig. 1 The supporting structures and grading of soft tissue damage.

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  Fig. 2 Grade I soft tissue damage according to the MRI finding. Rupture of ALL C6-7 and an avulsion fracture of the superior end plate of C7 (①).

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  Fig. 3 Grade II soft tissue damage according to the MRI finding. Rupture of the ALL (①) and posterior extrusion of the disc material (②) of C5-6 and 6-7.

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  Fig. 4 Grade III soft tissue damage according to the MRI finding. Rupture of ALL (①), posterior extrusion of disc material (②) and rupture of the PLL (③) of C4-5, C5-6 and C6-7.

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  Fig. 5 Grade IV soft tissue damage according to the MRI finding. Rupture of the ALL (①), posterior extrusion of disc material (②), rupture of the PLL (③) and rupture of the ligamentum flavum and interspinous ligament (④) of C5-6.

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  Fig. 6 Grade V soft tissue damage according to the MRI finding. Rupture of the ALL (①), posterior extrusion of disc material (②), rupture of the PLL (③), rupture of the ligamentum flavum and interspinous ligament (④), and rupture of the posterior neck muscle (⑤) of C3-4 and C4-5.

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