46-year-old male found down during fire. Evaluate for ligamentous injury Cervical spine:There is mild reversal of cervical lordosis at the C3-C4 level. Vertebral body heights are grossly maintained. Focus of increased T1 and T2 signal in the posterior aspect of the C5 vertebral body compatible with hemangioma.Anterior and posterior longitudinal ligaments as well as the ligamentum flavum appear intact. There is mildly increased T2 signal in the interspinous ligaments extending from C3 to C7 which may reflect mild ligamentous injury. No evidence of epidural hematoma. No evidence of hemorrhagic cord contusion.There is a large central disc protrusion at C3-C4 with mass effect and deformity of the cervical cord at this level. The anterior cord demonstrates increased T2 signal from C3 to C6 which may reflect gliosis with possible component of edema. Additional details as below.C2-C3: No disc bulge or spinal canal stenosis. No neural foraminal stenosis.C3-C4: Generalized disc bulge with focal central disc protrusion. There is complete effacement of the anterior and posterior thecal sac as well as focal mass effect and distortion of the underlying cord. Moderate left and mild right neural foraminal stenosis.C4-C5: Central disc protrusion with effacement of the ventral thecal sac results in mild spinal canal stenosis. No neural foraminal stenosis.C5-C6: Central disc protrusion slightly asymmetric to the right with effacement of the ventral thecal sac. Mild spinal canal stenosis. Minimal bilateral neural foraminal stenosis.C6-C7: Mild generalized disc bulge. No significant neural foraminal or spinal canal stenosis.C7-T1: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.
1. Increased T2 signal in the interspinous ligaments raising possibility of interspinous ligamentous injury. Remainder of the ligaments including the anterior and posterior longitudinal ligaments as well as the ligamentum flavum are intact. No evidence of epidural hematoma or hemorrhagic contusion involving the cervical cord.2. Large central disc protrusion at C3-4 with mass effect and deformity of the cervical cord at this level. Smaller disc protrusions are evident at the C4-C5 and C5-C6 levels with minimal to mild mass effect on the cord. There is abnormal T2 signal within the cervical cord from C3 to C6 which may reflect gliosis/myelomalacia although component of acute edema can not be entirely excluded.3. Moderate left C3-C4 neural foraminal stenosis.