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C5 Hyperflexion Teardrop
Case Detail
| Anatomy: Brain-Spine |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Trauma |
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| Created: over 2 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
CT
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Activities:  PDF  ImageJA |
History
Teenager found flaccid after fall of 30 feet from tree.
Case Images
Diagnosis
C5 Hyperflexion Teardrop
Findings
CT – Sagittal reconstructed image shows reversal of lordosis, anterior translation of C4 relative to C5, anterior wedging of C5 vertebral body and mild fanning of the spinous processes. Axial images show the sagittal fracture line in the vertebral body and right pedicolaminar fractures with involvement of the vertebral artery foramen.
Discussion
Hyperflexion teardrop fracture represents a significant injury. Posterior distraction leads to disruption of the posterior ligamentous complex (fanning of the posterior elements, reversal of lordosis and facet dislocation/subluxation), anterior and posterior longitudinal ligaments disruption and intervertebral annulus/disc injury. Anterior cord syndrome (immediate quadriplegia and loss of pain touch and temperature sensations, but with preserved proprioception and vibration sensation) is very common.
Reference
Harris JH and Mirvis SE. The radiology of acute cervical spine trauma, 3rd Ed. Williams and Wilkins (1996).