Author/Editor		Jonsson, Halldor; Bring, Gunilla; Rauschning, Wolfgang; Sahlstedt, Bo
Title		Hidden cervical spine injuries in traffic accident victims with skull fractures
Type		članek
Source		In: Komadina R, editor. Zbornik izbranih predavanj simpozija o nihajnih poškodbah vratne hrbtenice; 1998; Celje. Celje: Splošna in učna bolnišnica Celje, Služba za raziskovalno delo in izobraževanje,
Publication year		1998
Volume		str. 77-89
Language		eng
Abstract		We studied 22 cervical spines from traffic accident victims with fatal craniocerebral injuries (19 male victims and three female victims: mean age, 26 years). Two had parietal fractures, 20 had skull base fractures (seven ring frac- tures), and 16 had severe polytrauma. The spines with all soft tissues were frozen in situ and removed. Fine-focus specimen radiograms were taken in special views and evaluated by an expert orthopedic radiologist. The specimens were then cryo- sectioned, and all injuries were recorded at submillimeter intervals on high resolution film. Ten radiological fracture diagnoses were inconect; six were false positive, and four were false negative. In the upper cervical spine, only one of 10 gross ligamentous disruptions was suspected on the radiograms. In the lower cervical spine, 198 lesions were missed on the radiograms: 77 facet joint and ligamentum flavum injuries, 77 uncovertebral, and 22 disc lesions. ln two adolescents, eight cartilaginous end-plate avulsions of the discs were found. At second-look evaluation, only four of the 245 unrecognized bone and discoligamentous lesions were detected on the radiograms. All spines were injured. Multiple-level soft-tissue injuries were common.
Descriptors		CERVICAL VERTEBRAE SOFT TISSUE INJURIES SKULL FRACTURES AUTOPSY ACCIDENTS, TRAFFIC FATAL OUTCOME