Cervical spine injuries. Diagnosis and classification
J. L. Babcock
Roentogenographic techniques in the evaluation of the patient with a
cervical spine injury entail several considerations that should be
respected in defining and classifying the lesion according to the mechanism
of injury. Unilateral or bilateral facet dislocation with separation of
posterior elements usually implies disruptive flexion injury. Anterior
wedging of a vertebral body indicates flexion with some degree of
compression. Comminution of the vertebral body indicates a predominant
compressive element to the injury. An anterior-inferior marginal fracture
indicates extension injury. Impaction of the inferior articulating
processes or fracture of the pedicle producing a more horizontal appearance
of the facet indicates disruption of interspinous ligaments and the
probability that significant instability exists. Studies should not be
terminated until complete visualization of all cervical segments has been
obtained, including the cervico-thoracic junction.
