CTICasesTraumatic Thoracic Spine Fracture-Dislocation with Cord Transection and Paraspinal Hematoma
Imaging findings
A chest radiograph showed an abnormal mediastinum with bilateral paravertebral stripe thickening and biapical caps. CT confirmed a severe lateral fracture-dislocation of the thoracic spine, with complete cord transection at the T4 level. Associated findings included a large paraspinal hematoma and extrapleural hemorrhage in the apical regions.
Key takeaways
Severe blunt trauma, such as from a motor vehicle crash, can cause devastating thoracic spine injuries including fracture-dislocations and complete spinal cord transection. Radiographic signs like mediastinal widening, thickening of the paravertebral stripes, and apical caps are indirect indicators of paraspinal hematoma and extrapleural bleeding, which are common accompaniments of severe spinal trauma. These findings necessitate prompt and detailed cross-sectional imaging.
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