Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2007 Aug;42(4):433-443. Korean.
    Published online Aug 31, 2007.
    https://doi.org/10.4055/jkoa.2007.42.4.433
    Copyright © 2007 The Korean Orthopaedic Association
    Original Article

    Soft Tissue Damage in Cervical Spine Extension Injury

    Kyung-Jin Song, M.D., Gyu-Hyung Kim, M.D., Seong-Il Wang, M.D. and Ju-Hong Lee, M.D.
      • Department of Orthopedic Surgery, College of Medicine, Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
    • Address reprint requests to Kyung-Jin Song, M.D., Ph.D. Department of Orthopedic Surgery, Chonbuk University Hospital, 634-18, Geumam-dong, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82.63-250-1760, 1770, Fax: +82.63-271-6538, Email: kysong@chonbuk.ac.kr

    Abstract

    Purpose

    To diagnose the extent of soft tissue damage with MRI, and to evaluate the relationship between soft tissue damage and a spinal cord injury in an extension injury to the lower cervical spine trauma.

    Materials and Methods

    Eighty-one patients who treated surgically for an anextension injury to the cervical spine over the past 5 years, were analyzed. All patients had undergone MRI after the injury, and for the specific grading of soft tissue damage, the grades were defined from grades 1 to 5.

    Results

    The spinal cord injury developed with more than grade 3 soft tissue damage associated with a rupture of the posterior longitudinal ligament (p<0.01). The changes in signal intensity of the spinal cord also developed according to the severity of soft tissue damage (p<0.01). There was no relationship between the soft tissue damage and the spinal cord injury in spinal stenosis (p=0.75).

    Conclusion

    The extent of soft tissue damage was diagnosed precisely with MRI, and there was an close relationship between the soft tissue damage and spinal cord injury in the distractive-extension injury to the lower cervical spine trauma.

    Keywords
    Lower cervical trauma; Distractive-extension injury; Grading of soft tissue damage; Spinal cord injury

    Figures

    Fig. 1
    The supporting structures and grading of soft tissue damage.

    Fig. 2
    Grade I soft tissue damage according to the MRI finding. Rupture of ALL C6-7 and an avulsion fracture of the superior end plate of C7 (①).

    Fig. 3
    Grade II soft tissue damage according to the MRI finding. Rupture of the ALL (①) and posterior extrusion of the disc material (②) of C5-6 and 6-7.

    Fig. 4
    Grade III soft tissue damage according to the MRI finding. Rupture of ALL (①), posterior extrusion of disc material (②) and rupture of the PLL (③) of C4-5, C5-6 and C6-7.

    Fig. 5
    Grade IV soft tissue damage according to the MRI finding. Rupture of the ALL (①), posterior extrusion of disc material (②), rupture of the PLL (③) and rupture of the ligamentum flavum and interspinous ligament (④) of C5-6.

    Fig. 6
    Grade V soft tissue damage according to the MRI finding. Rupture of the ALL (①), posterior extrusion of disc material (②), rupture of the PLL (③), rupture of the ligamentum flavum and interspinous ligament (④), and rupture of the posterior neck muscle (⑤) of C3-4 and C4-5.

    Tables

    Table 1
    Overall Data in This Study

    Table 2
    The Inter-observer (K1) and Intra-observer (K2) Reliability of the Standard

    Table 3
    The Correlations between the Grade of Soft Tissue Damage and the Spinal Cord Injury

    Table 4
    Measurement of the Retropharyngeal and Retrotracheal Space

    Table 5
    The Correlations between Spinal Stenosis and the Spinal Cord Injury

    Table 6
    The Correlations between the Allen Classification and Grade of Soft Tissue Damage

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    MeSH Terms
    Humans
    Longitudinal Ligaments
    Magnetic Resonance Imaging
    Rupture
    Spinal Cord
    Spinal Cord Injuries
    Spinal Stenosis
    Spine*
    Metrics
    Share
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    Tables
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