C5 flexion teardrop fracture with cord contusion and hemorrhage
Findings:
Multiple CT images demonstrate a comminuted fracture of the C-5 vertebral body with significant retropulsion into the spinal canal causing canal compromise. The MR images were performed with the patient in traction and demonstrate improved canal compromise. The MR images also demonstrate extensive signal abnormality within the cervical cord extending from C3 through C7. The axial gradient echo images demonstrate patchy hemorrhagic changes within the cervical cord at this level.
Discussion:
The flexion teardrop fracture is considered to be one of the most devastating cervical spine injuries, with frequent significant cord injury. The presence of detectable cord hemorrhage significantly worsens prognosis. The fractures occur with axial loading and hyperflexion mechanism. The anterior fragment remains attached to the anterior longitudinal ligament, and the retropulsed large body fragment causes significant canal compromise. In this case, relative fluid signal along the anterior margin of the cervical cord indicates near transection of the cord.
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