The Hip: Preservation, Replacement and Revision

MRI in Cervical Fractures

- See:
  - MRI Spine: Discussion;
  -
Role of CT in C-spine Injuries:

- Discussion:
    - for visualizing soft tissue and neural elements, & unsuspected disc herniations in presence of cercial spine fractures;
    -
disc herniation may indicate disruption of anterior or posterior longitudinal ligament;
         - MRI is useful when traumatic disk herniation may accompany an injury;
    - differentiates cord edema from hemorrhage or vascular infarction;
    - is useful for delineating
SCIWORA syndrome;
    - for visualizing widening of the interspinous, interlaminar, or facet distances,
prevertebral soft tissue prominence
    - in pts w/ neurologic deficit - differentiate a compressive, extradural lesion from an intramedullary lesion injury;
    - epidural hematoma:
         - has a characteristic signal intensity, depending on age of the injury;
         - is not centered at the disc space;
         - preop knowledge of such space occupying compressive lesions is essential in pts who are considered for surgery;
         - intramedullary lesion, such as cord contussion, can be differentiated from hematoma on basis of signal characteristics obtained on both T1 and T2 weighted images;
         - intramedullary hematoma has mixed signal on short TR (T1) images & displays central low intensity surrounded by high intensity on long TR (T2) images;
         - cord edema has normal T1 intensity, & is homogenously hyperintense on long TR (T2) images;

- Contraindications:
    - pts w/ pacemaker, aneurysm clips, metallic fragments in eye or spinal cord, or severe claustrophobia


References 

Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation.

Magnetic resonance imaging evaluation of the cervical spine in the comatose or obtunded trauma patient.  

Magnetic resonance imaging for the evaluation of patients with occult cervical spine injury: MRI for the evaluation of patients with occult cervical spine injury

Acute cervical cord injury without fracture or dislocation of the spinal column



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, April 11, 2012 4:49 pm