Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI.
OBJECTIVE
We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries.


METHODS
Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18 81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury.


RESULTS
Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.3%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (p > 0.05).


CONCLUSIONS
Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the noncontiguous CTJ or upper thoracic spinal injury.
Choi
Soo-Jung
SJ
Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
Shin
Myung Jin
MJ
Kim
Sung Moon
SM
Bae
Sang-Jin
SJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D015994:Incidence; D017846:Longitudinal Ligaments / Q000293:injuries; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000175:diagnosis; D013124:Spinal Injuries / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D013233:Stellate Ganglion / Q000293:injuries; D013904:Thoracic Vertebrae / Q000293:injuries*; D014057:Tomography, X-Ray Computed