E2086. From Accidents to Zebras: A Pictorial Review of Spinal Trauma
  1. Sankarsh Jetty; University of Rochester Medical Center
  2. Bushra Ahmad; No Affiliation
  3. Attia Ahmad; Rowan University School of Medicine
  4. Alexander Kessler; University of Rochester Medical Center
Blunt and penetrating trauma is a frequent cause of visits to the emergency department with blunt trauma making up approximately 40% of all visits and penetrating trauma making up approximately 12% of all visits. Despite increased imaging utilization, injuries to the spinal cord are missed in 4 - 9% of patients. Knowledge of common fracture patterns and mechanisms of injury is crucial to making an accurate and timely diagnosis.

Educational Goals / Teaching Points
This exhibit includes a brief review of spinal anatomy, a review commonly used clinical and imaging classification systems, common pathology following spinal trauma, and mimics and pitfalls.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit covers anatomy (radiographic, cross-sectional, atlanto-occipital junction); classification (NEXUS criteria, AO spine); pitfalls/mimics (limbus vertebrae, pars defects, vascular channels, Os Odontoideum); Pathology (jefferson fracture, hangman fracture, clay shoveler’s fracture, burst fracture, chance fracture, simple compression fracture, flexion teardrop, extension teardrop, occipital condyle fracture, Types 1-3 odontoid fractures, cervical spine tubercle fractures, bamboo stick fracture, nerve root avulsion, spinal cord contusion, subdural hemorrhage, epidural hemorrhage, subarachnoid hemorrhage, atlanto-occipital dissociation, facet dislocation, traumatic disc herniation, ligamentous injuries).

Imaging of spinal trauma is a common occurrence in the emergency department and one that is encountered by the radiologist on a daily basis. A multimodality approach is often employed, beginning with radiography or CT and proceeding to MRI or MRA as warranted. An understanding of normal anatomy and common mimics and pitfalls of disease is important to prevent unnecessary further imaging or procedures.