Type:
Educational Exhibit
Keywords:
Trauma, MR, CT, Conventional radiography, Neuroradiology spine
Authors:
P. Nsiah-Sarbeng, A. Gontsarova, P. Bhogal, T. Wilhelm; London/UK
DOI:
10.1594/ecr2011/C-1740
Imaging findings OR Procedure details
Events leading to cervical spine injuries in the elderly are commonly considered as trial mechanism in younger adults.
Fall from standing from or seating heights are the most common causative mechanism for cervical spine injuries (2).
Majority of cervical spine injuries involves one or more levels of the cervicocranium with C2 injuries being the most common and injuries frequently asssociated with fractures of C1.
In the healthy young individual the most mobile segments are C4-C7 and not surprisingly the most common injuries in the age group occurs at this level.
In the elderly population these levels develop degenerative changes and become less mobile,
the C1-C2 levels become more mobile portion (3).
In the lower cervical spine the most common level involves C5 and C6; this is due to high frequency of hyperextension injury of the spondylotic lower cervical spine (6).
Imaging technique in the elderly are the same as in the young population. High quality lateral view is of prime importance,
however associated degenrative changes and decreased mental state makes proper patient positioning for obtaining diagnostic radiographs more difficult.
CT is the most cost-effective(4) screening tool for patients with high probability of acute cervical injury.
In the elderly,
the injury distribution,
frequency and mechanism support the lower threshold for use of CT.
MRI is the most important for evaluating spinal cord injuries(5).
We routinely obtain T1 and T2-weighted saggital images and axial T2-weighted images of the affected level.
For assessing oedema and/or haematoma in the paravertebral tissue as well as spinal cord,
saggital T2-weighted images are the most useful.