Neuro_MR_CSpine: 15 M, MVA, widening of disc space on CT.

MRI CERVICAL SPINE WITHOUT CONTRAST:

CLINICAL HISTORY: 15 years of age, Male, status post MVA. 

FINDINGS:

Alignment: Widening of the C6-C7 intervertebral disc space and left facet articulation as seen on same day CT.

Bone marrow:  

Disruption of the anterior longitudinal ligament with intervening fluid along the avulsion fracture at the C6 anterior inferior endplate and minimal associated marrow edema. Disruption of the posterior longitudinal ligament and at least partial-thickness disruption of the ligamentum flavum at the C6-7 level.

Vertebrae: No significant degenerative change. 

Cord: No cord signal abnormality.

Ventral epidural hematoma from the C5 level inferiorly, measuring up to 5 mm at the C7 level, that partially extends dorsally and left laterally from the C7 level inferiorly.

Extra-vertebral soft tissues:  

Fluid signal at the C2-3 through C5-6 interspinous regions which likely represents an interspinous ligamentous injury.

Long segment mild prevertebral edema and small hematoma adjacent to the C6-7 disc space.

Significant fluid signal in the suboccipital, bilateral posterior paraspinous, and left neck soft tissues, compatible with muscular strain. 

Edema in the left parotid space related to facial injuries.

Visualized brain: Normal.

Additional comment: Prominent adenoidal tissues, which are likely reactive and within normal limits for age. 

 

IMPRESSION:

1.  Three column fracture/subluxation at C6-C7 with disruption of the anterior longitudinal ligament, avulsion fracture at the C6 inferior endplate, disruption of the posterior longitudinal ligament, and at least partial-thickness disruption of the ligamentum flavum.

2.  Fluid signal at the C2-3 through C5-6 interspinous regions which likely represents an interspinous ligamentous injury.

3.  Ventral epidural hematoma from the C5 level inferiorly, measuring up to 5 mm at the C7 level. Hematoma extends left laterally to the dorsal space from C7.  No cord signal abnormality.