Magnetic Resonance Imaging in Cervical Spine Trauma: More Than Soft Tissue Illustration.

ABSTRACT

The role of magnetic resonance imaging (MRI) in cervical spine trauma is limited to visualizing soft tissues such as the intervertebral disc, the spinal cord, and hematomas. Herein, we present the case of a 60-year-old man who was transferred to our hospital with neck pain after a cervical spine trauma associated with a motor vehicle accident. The initial computed tomography imaging of the cervical spine showed stable linear fractures at the C2, C6, and C7 vertebral bodies, for which the patient received conservative management. The patient showed remarkable clinical improvement three months later, but the linear fractures at the subaxial spine remained unchanged on computed tomography (CT). Magnetic resonance imaging (MRI) scantly differentiated active from inactive bone lesions and prevented unnecessary interventions. Therefore, we suggest that the MRI is of value in cases with a clinical and radiological mismatch. A mismatch is considered in cases when there is a high level of clinical suspicion for a spinal fracture, whereas CT images fail to provide direct evidence of a bone fracture. In such cases, MRI offers indirect evidence of bony trauma, such as bone marrow edema, visualized as a high-intensity signal in T2-weighted images. Furthermore, specialized spine trauma MRI protocols could be of value in selected cases.