Cervical spine injuries. Diagnosis and classification.

Roentogenographic techniques in the evaluation of the patient with a cervical spine injury entail several considerations that should be respected in defining and classifying the lesion according to the mechanism of injury. Unilateral or bilateral facet dislocation with separation of posterior elements usually implies disruptive flexion injury. Anterior wedging of a vertebral body indicates flexion with some degree of compression. Comminution of the vertebral body indicates a predominant compressive element to the injury. An anterior-inferior marginal fracture indicates extension injury. Impaction of the inferior articulating processes or fracture of the pedicle producing a more horizontal appearance of the facet indicates disruption of interspinous ligaments and the probability that significant instability exists. Studies should not be terminated until complete visualization of all cervical segments has been obtained, including the cervico-thoracic junction.