More pathology of cervical SCI

1. What is the result of a flexion injury? How does it appear on X-ray? How is the spinal cord affected?
2. What is the most common level of injury and why?
3. How do hyperextension injuries usually occur? What is the type of SCI that results? What is seen on X-ray?
4. What is the most common level of injury?
5. What is the origin of most spinal cord tumors?
6. Where do spinal cord tumors usually occur? What part of the cord is compressed?

Answers:
1. Flexion injury results in dislocation of both facets and is an unstable injury. On X-ray, there is >50% displacement of the vertebral body. The spinal cord is greatly compromised, resulting in a likely complete injury.
2. C5-C6, because there is increased movement in this area.
3. Hyperextension usually occurs through acceleration/deceleration injuries, such as an MVA. This results in disruption of the anterior longitudinal ligament (stable) and central cord syndrome, which has more UE involvement than LE. X-ray shows possible soft tissue injury.
4. C4-C5.
5. Most s.c. tumors are metastatic and are extradural in origin (involve the vertebral bodies).
6. 70% occur in the thoracic spine, compressing the anterior aspect of the spinal cord.