[ 30 ] It is most frequently encountered in patients over the age of 50 with narrow spinal canals, and is typically correlated with acute hyperextension … -, Jackson AB, Dijkers M, Devivo MJ, Poczatek RB. Magnetic resonance was particularly helpful in diagnosing both intrinsic cord contusion and extradural compression. These are more or less anormal hyperextension injury that usually occurs on the road. Simple wedge fracture is the result of a pure flexion injury. -. This results inwhen a car with quite a slow speed strikes a vehicle in front of them. Common causes of these types of injuries are car accidents, diving in shallow waters, falls from horses, and football. To identify and evaluate diagnostic magnetic resonance imaging (MRI) features in patients with suspicion of discoligamentous cervical injury after hyperextension trauma of the cervical spine. Journal of Neurosurgery: Spine, 97(1), 25-32. FOIA BMC Musculoskelet Disord. 2012 Dec 1;37(25):E1560-6. Abstract. 2013 Feb 10;225(1-3):71-4. doi: 10.1016/j.forsciint.2012.04.035. The tear of the ALL at C5/6 was confirmed intraoperatively. Prevertebral hematoma, as an ancillary finding, is present (asterisk in A + B). [Multivariate analysis for prognostic factors on non-operative treatment of cervical spinal cord injury without fracture or dislocation]. Immunohistochemical and imaging studies indicate mild to moderate insult to axons and their ensheathing myelin in the lateral funiculi culminating in cytoskeletal injury and impaired conduction. CCS usually occurs in people with existing arthritis changes in the bones of the neck. Leg function usually returns first, followed by bladder control and then arm function. Enter and space open menus and escape closes them as well. Alternatively, if symptoms have come on slowly and are not the result of a sudden accident, consult a spine specialist, such as a neurosurgeon. Epub 2012 May 28. Patient Pages are authored by neurosurgical professionals, with the goal of providing useful information to the public. 2005 Oct;237(1):106-13. doi: 10.1148/radiol.2371040697. Epub 2020 Dec 22. Professor, Neurological Surgery, Radiology and Public Health Sciences Keywords: hyperextension cervical spine injury. But any impact that causes the forceful flexion and hyperextension of the neck can result in this injury. MR imaging of acute cervical spinal ligamentous and soft tissue trauma. Abraham Schlauderaff, MD However, CCS may occur in patients of any age and can be seen in athletes who present with not only hyperextension injuries to their neck, but associated ruptured disc(s) that cause compression of the spinal cord. A hyperextension/flexion injury most often impacts the cervical spine between the C4-C7 vertebrae. Cervical hyperextension injuries are common and often show minimal radiographic abnormalities, even with severe or unstable lesions. However, with advanced imaging technology, patients with compression of the spinal cord secondary to traumatic herniated discs and other structurally compressive lesions can be quickly diagnosed and surgically decompressed. Tear of the ALL at C3/4 and C4/5 was confirmed intraoperatively (images are zoomed for better visualization). The prognosis for CCS in younger patients is better than in older patients. The National Institutes of Neurological Disorders and Stroke website, Neurosurgery Research & Education Foundation. Emerg Radiol 2012;19:277‐86. Complete tear of the anterior longitudinal ligament (ALL) at C5/6 only depicted with short tau inversion recovery (white arrow in A). Kevin M. Cockroft, MD, FAANS 24 (1):195-202, 2015. Zhang T, Wu J, Chen YC, Wu X, Lu L, Mao C. Med Sci Monit. A 70‐year‐old male patient after a heavy fall. CCS affects males more frequently than females. In addition, cervical hyperextension injury was suspected because of mild anterior opening of the C4/5 and multiple spinous process fractures. Magnetic Resonance Imaging has Better Accuracy in Detecting New-Onset Rib Fractures as Compared to Computed Tomography. The upper cervical spine goes into hyperextension with the lordosis curve becoming more pronounced. MRI is then the only modality to show a pathology to the spinal cord. Spinal Cord. Background and purpose: The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. MR imaging findings in spinal ligamentous injury. Left and right arrows move across top level links and expand / close menus in sub levels. Asian Spine J. Central cord syndrome (CCS) is an incomplete traumatic injury to the cervical spinal cord – the portion of the spinal cord that runs through the bones of the neck. Sagittal short tau inversion recovery images on the left (A + C) were able to depict tearing of the anterior longitudinal ligament (ALL) at C3/4 and C4/5 (white arrows). The overall percent agreement between STIR and intraoperative findings was 90.9% (AC1 = .881) and for T2 69.7% (AC1 = .498). If the spinal cord becomes compressed or inflamed by a cervical herniated disc, signs and symptoms may include: Pain, tingling, numbness, and/or weakness in both arms and/or both legs Problems with coordination or walking Difficulty with bladder and/or bowel control About 15-25% of incomplete spinal cord injuries result in central cord syndrome. Hogan GJ, Mirvis SE, Shanmuganathan K, Scalea TM. The site navigation utilizes arrow, enter, escape, and space bar key commands. Since the spinal cord is organized with the nerves that control the movement of the arms in the center and the nerves going to the legs more toward the outside, the arms are affected more than the legs in this situation. - Hyperextension fracture dislocation. As a result, patients with CCS tend to be weaker in the arms than in the legs. the spinal cord is squeezed or pinched between pre-existing anterior cervical spondylotic bone spurs and a thickened posterior intraspinal canal ligament, the ligamentum flavum. Nikolai Bogduk, MD, PhD, in a recent narrative review published in Spine, summarized evidence which demonstrates that injuries to the cervical zygapophysial (also known as facet) joints are the primary source of pain following hyperflexion-hyperextension injuries … Among other structures we evaluated the following: prevertebral hematoma, anterior longitudinal ligament (ALL), intervertebral disc, and spinal cord. noted that TCCS is the most common form of an incomplete SCI [ Table 2 ]. A 53‐year‐old patient after a ski accident with hyperextension injury of the cervical…, Sagittal short tau inversion recovery images on the left (A + C) were…, Complete tear of the anterior longitudinal ligament (ALL) at C5/6 only depicted with…, A 70‐year‐old male patient after a heavy fall. -, Benedetti PF, Fahr LM, Kuhns LR, Hayman LA. © 2021 American Association of Neurological Surgeons. - Hangman's frx. Learn more about the NREF and make a donation today. An epidemiologic study of 103 patients with upper cervical spine trauma identified high energy and hyperextension as the most frequent injury mechanisms in the age-group of 18-64 years. There, medical providers are able to evaluate and obtain the appropriate tests to determine the cause of symptoms. If the above symptoms develop after an accident or injury, seek urgent medical attention at a local emergency department. Are the most common cervical vertebrae injuries and usually result from a severe hyperextension or hyperflexion of the head and the neck. TCCS typically occurs in patients over the age of 50 with a narrow spinal canal and follows an acute hyperextension injury of the cervical spine. Class of neck injuries typically seen in rapid, forceful extension of the cervical spine Flexion–extension injuries (“whiplash”) are usually from motor vehicle accidents (MVAs).