Cervical Anatomy and Pathology - Cervical Spine

Lower cervical spine of a young male adult who sustained a dislocation with complete tetraplegia in a motor vehicle accident. Several closed reduction attempts were done without lasting success. The patient died from massive aspiration of blood from a stress ulcus hemorrhage. This paramedian sagittal section shows the anterior subluxation of the upper vertebra from which the annulus fibrosus and the periosteum and posterior longitudinal ligaments are stripped along the entire posterior surface of the vertebra, forming a triangular pouch into which large hinged disc fragments are dislodged. A small triangular ridge from the lower posterior endplate of the upper vertebra effectively traps the disc fragments. Axial traction obviously would increase spinal cord compression. Note also the hemorrhage posteriorly in the disc above the fracture and the complete rupture of the inter–laminar ligamentum flavum.