Assessment of Post-Traumatic Upper Cervical Spine Instability by Conventional Radiography, CT and MRI
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Purpose: is to study the radiological characteristics of upper cervical spine injuries regarding their stability and instability and to discuss the role of imaging modalities in their evaluation. Patients and methods: this study included 30 patients with unstable traumatic upper cervical spine injuries having variable neurologic symptoms referred to radiology department of Benha university. Patients were investigated by different radiological modalities including plain radiographs, CF and MR' Results: Unstable dens fractures was the commonest type of injury found in 12 cases (40%) followed by atlanto-axial subluxations that were detected in 10 cases (33.3%). Cases of unstable Hangman's fracture were 3 (10%). Jefferson's fracture and atypical spondylolisthesis of the axis were the minority, each of them represented 6.7% of cases. Conclusion: MRI is the most sensitive modality in detection of spinal instability, especially when kinematic MRI is used followed by dynamic radiographs. MRI is also the most sensitive modality in detection of atlanto-axial instabilities, soft tissue injuries (especially ligamentous) and facetal instability while CT is sensitive modality in detection of fractures and intraspinal bone fragments.