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Cervical Hyperextension-Rotation Injury
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Pedicolaminar fracture-separation
            • Definitions

              • Hyperextension injury to cervical spine with off-center force vector causing rotation and asymmetric injury

            IMAGING

            • General Features

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Walters BC et al: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 60 Suppl 1:82-91, 2013
                            2. Munera F et al: Imaging Evaluation of Adult Spinal Injuries: Emphasis on Multidetector CT in Cervical Spine Trauma. Radiology. 263(3):645-60, 2012
                            3. Bono CM et al: Reproducibility of radiographic measurements for subaxial cervical spine trauma. Spine (Phila Pa 1976). 36(17):1374-9, 2011
                            4. Vaccaro AR et al: The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 32(21):2365-74, 2007
                            5. Rao SK et al: Spectrum of imaging findings in hyperextension injuries of the neck. Radiographics. 25(5):1239-54, 2005
                            6. Lifeso RM et al: Anterior fusion for rotationally unstable cervical spine fractures. Spine. 25(16):2028-34, 2000
                            7. Klein GR et al: Efficacy of magnetic resonance imaging in the evaluation of posterior cervical spine fractures. Spine. 24(8):771-4, 1999
                            8. Makan P: Neurologic compromise after an isolated laminar fracture of the cervical spine. Spine. 24(11):1144-6, 1999
                            9. London PS: Extension injuries of the neck. Injury. 18(4):223, 1987
                            10. Allen BL Jr et al: A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine (Phila Pa 1976). 7(1):1-27, 1982
                            11. Woodring JH et al: Fractures of the articular processes of the cervical spine. AJR Am J Roentgenol. 139(2):341-4, 1982
                            12. Dolan KD: Cervical spine injuries below the axis. Radiol Clin North Am. 15(2):247-59, 1977
                            13. Nieminen R: Fractures of the articular processes of the lower cervical spine. An analysis of 28 cases treated conservatively. Ann Chir Gynaecol Fenn. 63(3):204-11, 1974
                            14. Frankel H et al: Closed injuries of the cervical spine and spinal cord: results of conservative treatment of extension rotation injuries of the cervical spine with tetraplegia. Proc Veterans Adm Spinal Cord Inj Conf. (19):52-5, 1973
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Pathology

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Synonyms

                                        • Pedicolaminar fracture-separation
                                      • Definitions

                                        • Hyperextension injury to cervical spine with off-center force vector causing rotation and asymmetric injury

                                      IMAGING

                                      • General Features

                                        • MR Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Walters BC et al: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 60 Suppl 1:82-91, 2013
                                                      2. Munera F et al: Imaging Evaluation of Adult Spinal Injuries: Emphasis on Multidetector CT in Cervical Spine Trauma. Radiology. 263(3):645-60, 2012
                                                      3. Bono CM et al: Reproducibility of radiographic measurements for subaxial cervical spine trauma. Spine (Phila Pa 1976). 36(17):1374-9, 2011
                                                      4. Vaccaro AR et al: The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 32(21):2365-74, 2007
                                                      5. Rao SK et al: Spectrum of imaging findings in hyperextension injuries of the neck. Radiographics. 25(5):1239-54, 2005
                                                      6. Lifeso RM et al: Anterior fusion for rotationally unstable cervical spine fractures. Spine. 25(16):2028-34, 2000
                                                      7. Klein GR et al: Efficacy of magnetic resonance imaging in the evaluation of posterior cervical spine fractures. Spine. 24(8):771-4, 1999
                                                      8. Makan P: Neurologic compromise after an isolated laminar fracture of the cervical spine. Spine. 24(11):1144-6, 1999
                                                      9. London PS: Extension injuries of the neck. Injury. 18(4):223, 1987
                                                      10. Allen BL Jr et al: A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine (Phila Pa 1976). 7(1):1-27, 1982
                                                      11. Woodring JH et al: Fractures of the articular processes of the cervical spine. AJR Am J Roentgenol. 139(2):341-4, 1982
                                                      12. Dolan KD: Cervical spine injuries below the axis. Radiol Clin North Am. 15(2):247-59, 1977
                                                      13. Nieminen R: Fractures of the articular processes of the lower cervical spine. An analysis of 28 cases treated conservatively. Ann Chir Gynaecol Fenn. 63(3):204-11, 1974
                                                      14. Frankel H et al: Closed injuries of the cervical spine and spinal cord: results of conservative treatment of extension rotation injuries of the cervical spine with tetraplegia. Proc Veterans Adm Spinal Cord Inj Conf. (19):52-5, 1973