-2 :: Case - 10900 :: - Hyperflexion Injury of the Thoracic Spine with spinal cord hematoma
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Tx and Followup:
Posterior spinal fusion from T4-T7.

Discussion Author(s): Richard P Moser III

Hyperflexion injuries are common, accounting for up to 50% of spinal injuries, and include a spectrum of radiographic abnormalities. The mechanism of the hyperflexion injury is usually a significant force resulting primarily in distraction of the posterior structures, with a lesser force vector resulting in compression of the anterior spinal column.

The spectrum of injuries ranges from the relatively stable “hyperflexion sprain” to the unstable flexion injuries (flexion teardrop fractures and bilateral locked/jumped facets).

The “hyperflexion sprain” is a ligamentous injury associated with varying degrees of disruption of the posterior ligaments (progressively involving the supraspinous ligaments, interspinous ligaments, facet joint capsules, and posterior longitudinal ligament, respectively), usually without associated fractures. These patients present with persistent pain, muscle spasms and, occasionally, mild reversible neurologic defects.

Radiographic abnormalities, when they are present, include widening of the interspinous distance or posterior aspect of the apophyseal joints, and/or localized kyphotic angulation of the cervical spine.

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