SAQ 241 – Trauma – unstable cervical spine flexion-teardrop injury

Question 3. unstable cervical spine flexion-teardrop injury.

a. X-ray findings

• Posterior displacement of C5 on C6 by approximately 25% of the vertebral-body width.
• Displaced anterior flexion-teardrop fracture of C5.
• C5 and C6 spinous-process fractures.
• Disruption of the anterior spinal line at C5-C6.
• Disruption of the posterior spinal or spinolaminar line.
• Prevertebral soft-tissue swelling.

b. Stability

• Unstable injury.

c. Reason

• Anterior and posterior longitudinal ligament disruption, producing a three-column injury.

d. Immobilisation problems

• Discomfort, headache, or mandibular pain.
• Neurological deterioration if immobilised away from neutral alignment.
• Reduced access to and visualisation of the neck and occiput.
• Pressure injury.
• Raised intracranial pressure.
• More difficult airway management or intubation.
• Aspiration risk.
• Deep-vein thrombosis risk.