Article Figures & Data
Figures
- Fig 1.
A 58-year-old man who sustained a unilateral interfacetal dislocation at C5–C6 without SCI.
A, Sagittal T2-weighted fast spin-echo (FSE) image (TR/TE/ETL: 2000/80/8) shows an injured disk at C5–C6 with increased signal intensity in the disk and probably avulsion of the anterior longitudinal ligament (dashed arrow). Prevertebral edema (arrowheads) and edema in the posterior paraspinal musculature (white arrows) are present.
B, Nonvisualization of the right vertebral artery. MIP image (anterior view) from a 2D time-of-flight acquisition (TR/TE/flip: 40/8.7/30) shows absence of signal intensity in the expected course of the right vertebral artery (dotted line).
C, Thrombus in the right foramen transversarium. Axial image from a 3D GRE acquisition (TR/TE/flip: 37/min/15) shows an oval area of low signal intensity in the right foramen transversarium corresponding to thrombus in the right vertebral artery. Note the normal flow-related enhancement in the left foramen transversarium.
D, Thombus in the right vertebral artery. Axial FSE image (TR/TE/ETL: 3000/28/4) obtained at a similar level to image in panel C shows a high-signal-intensity thrombus (arrow) in the right foramen transversarium indicative of a thrombosed vertebral artery. Note the normal flow void of the left vertebral artery in the left foramen transversarium.
Tables
ASIA Grade Description A No motor or sensory function preserved in the sacral segments B Sensory but not motor function preserved in at least the sacral segments C Motor function preserved below the neurologic level and most key muscles have motor score <3 D Motor function preserved below the neurologic level and most key muscles have a motor score of ≥3 E Motor and sensory function is normal. Note.—ASIA indicates American Spinal Injury Association. Adapted from Ditunno (6).
- TABLE 2:
Demographic summary of study population, including ASIA impairment grade, etiology, level of bony injury, and neurologic level of injury
(N = 63) % (n) Patients Male 71 (449) Female 29 (183) Mean age (y) 48.6 (12–102) ASIA impairment grade A 34 (115) B 13 (42) C 25 (83) D 28 (94) E 47 (298) Etiology Fall 43 (270) Automobile crash 34 (213) Not specified 7 (46) Diving accident 6 (39) Pedestrian accident 3 (17) Assault 2 (13) Sports injury 2 (13) Motorcycle crash 2 (12) Projectile 1 (9) Level of bony injury C1 3 (32) C2 5 (52) C3 9 (82) C4 18 (168) C5 26 (246) C6 26 (247) C7 13 (120) Neurologic level of injury C2 2 (11) C3 3 (16) C4 22 (141) C5 16 (103) C6 8 (49) C7 2 (11) C8 0.5 (3) No level (ASIA E) 47 (298) Note.—ASIA indicates American Spinal Injury Association.
Multiple fractures were possible in individual patients.
- TABLE 3:
Demographic data of patients with proved vertebral artery thrombosis (VAT), including ASIA impairment grade, etiology, level of bone injury, and neurologic level of injury
(N = 83) % (n) Patients with VAT Male 76 (63) Female 24 (20) Mean age (y) 44 (14–88) Vertebral artery affected Left 48 (42) Right 43 (37) Both 9 (4) ASIA impairment grade A 30 (25) B 7 (6) C 11 (9) D 11 (9) E 41 (34) Etiology Automobile crash 45 (37) Fall 28 (23) Sports injury 12 (10) Other 15 (13) Level of bony injury C1 3 (5) C2 4 (6) C3 6 (10) C4 21 (34) C5 33 (55) C6 24 (39) C7 9 (14) Neurologic level of injury C3 5 (3) C4 28 (23) C5 18 (15) C6 6 (5) C7 1 (2) C8 1 (2) No neurologic level 41 (34) Note.—ASIA indicates American Spinal Injury Association.
Multiple fractures were possible in individual patients.
- TABLE 4:
Comparison of patient demographics, ASIA neurologic impairment score, and neurologic level of injury for patients included and excluded from analysis
Included Excluded Total Number 635 648 1280* Average age (y) 49 53 102 Male 452 408 860 Female 183 240 423 ASIA impairment grade A 115 92 207 B 42 29 71 C 83 57 140 D 94 49 143 E 298 417 715 Level of injury C1 0 6 6 C2 11 18 29 C3 16 19 35 C4 141 81 222 C5 104 61 165 C6 50 21 71 C7 11 17 28 C8 3 6 9 Note.—ASIA indicates American Spinal Injury Association. Populations differed statistically with respect to sexual distribution (P < .01) and neurologic level (P < .001), but not for age (P < 1) or neurologic deficit (ASIA impairment grades A–D, P <.939).
* Three patients were excluded because of unavailable clinical data.
