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Spine
Diagnosis
Trauma
Vertebral Column, Discs, and Paraspinal Muscle
Ligamentous Injury
Ligamentous Injury
Jeffrey S. Ross, MD
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        • Diagnostic Checklist

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                Selected References

                                1. VandenBerg J et al: Blunt thoracolumbar-spine trauma evaluation in the emergency department: a meta-analysis of diagnostic accuracy for history, physical examination, and Imaging. J Emerg Med. 56(2):153-65, 2019
                                2. Inaba K et al: Cervical spinal clearance: a prospective Western Trauma Association multi-institutional trial. J Trauma Acute Care Surg. 81(6):1122-30, 2016
                                3. Aarabi B et al: Subaxial cervical spine injury classification systems. Neurosurgery. 72 Suppl 2:170-86, 2013
                                4. Rihn JA et al: Using magnetic resonance imaging to accurately assess injury to the posterior ligamentous complex of the spine: a prospective comparison of the surgeon and radiologist. J Neurosurg Spine. 12(4):391-6, 2010
                                5. Malham GM et al: Traumatic cervical discoligamentous injuries: correlation of magnetic resonance imaging and operative findings. Spine (Phila Pa 1976). 34(25):2754-9, 2009
                                6. Vaccaro AR et al: Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging. Spine (Phila Pa 1976). 34(23):E841-7, 2009
                                7. Hwang H et al: Threshold cervical range-of-motion necessary to detect abnormal intervertebral motion in cervical spine radiographs. Spine (Phila Pa 1976). 33(8):E261-7, 2008
                                8. 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
                                9. Krakenes J et al: Magnetic resonance imaging assessment of craniovertebral ligaments and membranes after whiplash trauma. Spine (Phila Pa 1976). 31(24):2820-6, 2006
                                10. Albrecht RM et al: Severity of cervical spine ligamentous injury correlates with mechanism of injury, not with severity of blunt head trauma. Am Surg. 69(3):261-5; discussion 265, 2003
                                11. Mirza SK et al: Classifications of thoracic and lumbar fractures: rationale and supporting data. J Am Acad Orthop Surg. 10(5):364-77, 2002
                                12. Vaccaro AR et al: Magnetic resonance imaging analysis of soft tissue disruption after flexion-distraction injuries of the subaxial cervical spine. Spine (Phila Pa 1976). 26(17):1866-72, 2001
                                13. Yoganandan N et al: Whiplash injury determination with conventional spine imaging and cryomicrotomy. Spine (Phila Pa 1976). 26(22):2443-8, 2001
                                14. Benedetti PF et al: MR imaging findings in spinal ligamentous injury. AJR Am J Roentgenol. 175(3):661-5, 2000
                                15. Keiper MD et al: MRI in the assessment of the supportive soft tissues of the cervical spine in acute trauma in children. Neuroradiology. 40(6):359-63, 1998
                                16. Dickman CA et al: Injuries involving the transverse atlantal ligament: classification and treatment guidelines based upon experience with 39 injuries. Neurosurgery. 38(1):44-50, 1996
                                17. 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
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Imaging

                                  • Pathology

                                    • Clinical Issues

                                      • Diagnostic Checklist

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • CT Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Natural History & Prognosis

                                                            DIAGNOSTIC CHECKLIST

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. VandenBerg J et al: Blunt thoracolumbar-spine trauma evaluation in the emergency department: a meta-analysis of diagnostic accuracy for history, physical examination, and Imaging. J Emerg Med. 56(2):153-65, 2019
                                                              2. Inaba K et al: Cervical spinal clearance: a prospective Western Trauma Association multi-institutional trial. J Trauma Acute Care Surg. 81(6):1122-30, 2016
                                                              3. Aarabi B et al: Subaxial cervical spine injury classification systems. Neurosurgery. 72 Suppl 2:170-86, 2013
                                                              4. Rihn JA et al: Using magnetic resonance imaging to accurately assess injury to the posterior ligamentous complex of the spine: a prospective comparison of the surgeon and radiologist. J Neurosurg Spine. 12(4):391-6, 2010
                                                              5. Malham GM et al: Traumatic cervical discoligamentous injuries: correlation of magnetic resonance imaging and operative findings. Spine (Phila Pa 1976). 34(25):2754-9, 2009
                                                              6. Vaccaro AR et al: Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging. Spine (Phila Pa 1976). 34(23):E841-7, 2009
                                                              7. Hwang H et al: Threshold cervical range-of-motion necessary to detect abnormal intervertebral motion in cervical spine radiographs. Spine (Phila Pa 1976). 33(8):E261-7, 2008
                                                              8. 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
                                                              9. Krakenes J et al: Magnetic resonance imaging assessment of craniovertebral ligaments and membranes after whiplash trauma. Spine (Phila Pa 1976). 31(24):2820-6, 2006
                                                              10. Albrecht RM et al: Severity of cervical spine ligamentous injury correlates with mechanism of injury, not with severity of blunt head trauma. Am Surg. 69(3):261-5; discussion 265, 2003
                                                              11. Mirza SK et al: Classifications of thoracic and lumbar fractures: rationale and supporting data. J Am Acad Orthop Surg. 10(5):364-77, 2002
                                                              12. Vaccaro AR et al: Magnetic resonance imaging analysis of soft tissue disruption after flexion-distraction injuries of the subaxial cervical spine. Spine (Phila Pa 1976). 26(17):1866-72, 2001
                                                              13. Yoganandan N et al: Whiplash injury determination with conventional spine imaging and cryomicrotomy. Spine (Phila Pa 1976). 26(22):2443-8, 2001
                                                              14. Benedetti PF et al: MR imaging findings in spinal ligamentous injury. AJR Am J Roentgenol. 175(3):661-5, 2000
                                                              15. Keiper MD et al: MRI in the assessment of the supportive soft tissues of the cervical spine in acute trauma in children. Neuroradiology. 40(6):359-63, 1998
                                                              16. Dickman CA et al: Injuries involving the transverse atlantal ligament: classification and treatment guidelines based upon experience with 39 injuries. Neurosurgery. 38(1):44-50, 1996
                                                              17. 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