Presentation
Motor vehicle accident with unrestrained driver. Weakness of the lower extremities.
Patient Data
There is a widening of the interspinous space between the C6 and C7 spinous processes. There is also mild widening involving the posterior C6/C7 interspinous disc space.
The left inferior articular process of C6 is distracted anteriorly from the superior articular process of C7 uncovertebral of the articular surface.
There is widening of the interspinous space between C6 and C7. There is distraction of the left inferior articular process of C6 from the superior articular process of C7 consistent with unilateral perched facet.
There is high T2/STIR signal involving the anterior longitudinal ligament, posterior longitudinal ligament, and ligamentum flavum at the level of C6 and C7, as well as high STIR signal within the interspinous ligaments at C5-C6, C6-C7, and C7-T1. There is extensive T2/STIR signal involving the posterior paraspinal muscles bilaterally. There is fluid within the retropharyngeal space.
There is a high T2/STIR signal within the spinal cord at C6-C7.
Case Discussion
This is a case of a spinal cord injury.
The patient underwent emergent neurosurgical intervention where she received an open reduction and internal fixation and anterior cervical diskectomy, decompression, and fusion at C6-C7. She also received anterior plate instrumentation at C6-C7.
A follow-up MRI of the cervical spine (not shown) demonstrated myelomalacia and atrophy of the spinal cord in the region of the T2/STIR hyperintensity seen in this case. The patient experienced long-term muscle rigidity and weakness.
Co-author:
Morgan Zhao, MD
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