Presentation
Motor vehicle accident. The seatbelt was only around the waist during the accident.
Patient Data
There is a fracture of the T3 vertebral body with separation of the posterior elements. There appears to be a linear bone fragment arising from the superior endplate of T3 with air between the fragment and the remaining T3 body. There is an associated paraspinal hematoma and probable associated intrathecal and intramedullary hematoma.
Other traumatic findings include a small-moderate right apical pneumothorax, trace left apical pneumothorax, and pulmonary contusions.
There is a Chance fracture T3 with severe collapse of the vertebral body. There is widening of the interspinous distance and focal kyphosis at T2-T4. There is a tear of the anterior longitudinal ligament, posterior longitudinal ligament, and ligamentum flavum (which is most severe from T2-T6).
At T3, there is severe, heterogeneous signal appearance to the cord. There is a large cord hemorrhage noted at T3-T6 level and edema with a heterogeneous appearance.
There is diffuse epidural hematoma from the cervical medullary junction extending to at least mid thoracic spine.
Case Discussion
This is a case of a spinal cord transection in a pediatric patient.
The patient underwent emergent neurosurgical intervention for stabilization/plating. The patient did not regain sensorimotor function.
Co-author:
Morgan Zhao, MD
Unable to process the form. Check for errors and try again.