![]() Injuries of the subaxial cervical spine occur along a wide spectrum of severity, from minor soft tissue “strains” to disastrous fracture dislocations with extensive spinal cord mutilation. This region accounts for about 65 % of fractures and more than 75 % of all dislocations in the spine, with fractures occurring most often at C6 and C7, and dislocations occurring most frequently between C5–C6 and C6–C7 vertebrae. The subaxial cervical spine (C3–C7) is particularly vulnerable to traumatic injury due to its considerable mobility and its close proximity to the more rigid thoracic spine. The prevalence is likely to be significantly higher in patients with head trauma and those who are unconscious at presentation. ![]() Falls, assault, penetrating and sports injuries form the remaining causes of spinal injury. The commonest cause of these injuries is road traffic accidents. Injuries to the spinal column are frequently seen in clinical practice. This approach also helps to differentiate look-alike injuries with different clinical implications.Biomechanics-based CT reading will help to rapidly and accurately identify the entire spectrum of injury.Bilateral facet dislocation is the most severe injury of the flexion-distraction spectrum.Compressive forces result in fracture and distractive forces result in ligamentous disruption.Vertebral bodies and disc bear the axial compression forces, while the ligaments bear the distraction forces.It will also enable the radiologist in writing clinically relevant CT reports of cervical spine trauma. This review will emphasise the variables on CT that affect the surgical management, as well as imaging “pearls” in differentiating “look-alike” lesions with different surgical implications. Mechanical considerations are important in most clinical and surgical decisions to adequately realign the spine, to prevent neurological deterioration and to facilitate appropriate stabilisation. This systematic and focused analysis enables a more accurate and rapid interpretation of cervical spine CT examinations. This article will review the fundamental biomechanical forces underlying the common subaxial spine injuries and resultant injury patterns or “fingerprints” on MDCT. MDCT provides an insight into the injury morphology, which in turn reflects the mechanics of injury. Multidetector computed tomography (MDCT) is routinely performed to evaluate acute cervical spine trauma, very often as first-line imaging. Subaxial cervical spine (C3–C7) trauma encompasses a wide spectrum of osseous and ligamentous injuries, in addition to being frequently associated with neurological injury. Injuries to the spinal column are common and road traffic accidents are the commonest cause.
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