Combined flexion and extension cervical spine fractures with vascular injury.

We present a radiologic case report of a combined flexion and extension cervical spine fractures with associated vascular injury in a young patient who presented after a motorcycle crash with bilateral upper extremity paresthesias. CT and MRI examinations demonstrated an unstable anterior spondylolisthesis at C7/T1 with laminar/spinous process fracture of C7 and posterior longitudinal ligament avulsion requiring emergent surgery. Patient also had an extension teardrop fracture of C2 and focal right vertebral artery dissection. The case report reviews the classification of cervical spine injuries both by mechanism of injury and by stability/instability classification. Finally, we discuss the etiology and diagnosis of vascular injury including injury patterns that predispose to vascular trauma.