Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

John A. Carrino, Geoffrey L. Manton, William B. Morrison, Alex R. Vaccaro, Mark E. Schweitzer, Adam E. Flanders

Research output: Contribution to journalArticle

Abstract

Objective: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Design: Retrospective case series. Patients: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. Results: The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). Conclusions: In contradistinction to the existing concept, the posterior longitudinal ligament can remain intact in a substantial proportion of hyperflexion injuries that produce bilateral cervical facet dislocation. Posterior longitudinal ligament integrity is not associated with any other injury pattern related to the anterior longitudinal ligament, intervertebral disc or facet fracture.

Original languageEnglish (US)
Pages (from-to)510-514
Number of pages5
JournalSkeletal Radiology
Volume35
Issue number7
DOIs
StatePublished - Jul 2006
Externally publishedYes

Fingerprint

Longitudinal Ligaments
Spine
Wounds and Injuries
Ligaments
Intervertebral Disc

Keywords

  • Spine, dislocation
  • Spine, injuries
  • Spine, MR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Carrino, J. A., Manton, G. L., Morrison, W. B., Vaccaro, A. R., Schweitzer, M. E., & Flanders, A. E. (2006). Posterior longitudinal ligament status in cervical spine bilateral facet dislocations. Skeletal Radiology, 35(7), 510-514. https://doi.org/10.1007/s00256-006-0115-3

Posterior longitudinal ligament status in cervical spine bilateral facet dislocations. / Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Vaccaro, Alex R.; Schweitzer, Mark E.; Flanders, Adam E.

In: Skeletal Radiology, Vol. 35, No. 7, 07.2006, p. 510-514.

Research output: Contribution to journalArticle

Carrino, JA, Manton, GL, Morrison, WB, Vaccaro, AR, Schweitzer, ME & Flanders, AE 2006, 'Posterior longitudinal ligament status in cervical spine bilateral facet dislocations', Skeletal Radiology, vol. 35, no. 7, pp. 510-514. https://doi.org/10.1007/s00256-006-0115-3
Carrino JA, Manton GL, Morrison WB, Vaccaro AR, Schweitzer ME, Flanders AE. Posterior longitudinal ligament status in cervical spine bilateral facet dislocations. Skeletal Radiology. 2006 Jul;35(7):510-514. https://doi.org/10.1007/s00256-006-0115-3
Carrino, John A. ; Manton, Geoffrey L. ; Morrison, William B. ; Vaccaro, Alex R. ; Schweitzer, Mark E. ; Flanders, Adam E. / Posterior longitudinal ligament status in cervical spine bilateral facet dislocations. In: Skeletal Radiology. 2006 ; Vol. 35, No. 7. pp. 510-514.
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