Radiologic Characteristics of Vertebral Artery Injury in the Cervical Spine Fracture

Myun Whan Ahn; Byung Sik Kong; Jung Rae Kim; Ji Hoon Shin

doi:10.4184/jkss.2011.18.3.91

Journal List > J Korean Soc Spine Surg > v.18(3) > 1075965

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Ahn, Kong, Kim, and Shin: Radiologic Characteristics of Vertebral Artery Injury in the Cervical Spine Fracture

Original Article

Journal of Korean Spine Surg 2011;18(3):91-95.

Published online: 21 September 2011

DOI: https://doi.org/10.4184/jkss.2011.18.3.91

Radiologic Characteristics of Vertebral Artery Injury in the Cervical Spine Fracture

Myun Whan Ahn, M.D., Byung Sik Kong, M.D., Jung Rae Kim, M.D., Ji Hoon Shin, M.D.

Department of Orthopedic Surgery Yeung Nam University Hospital, Daegu, Korea

Corresponding author: Myun Whan Ahn, M.D. Department of Orthopaedic Surgery, College of medicine, Yeungnam University, Daemyungdong 317-1, Namgu, Daegu, Korea TEL: 82-53-620-3640, FAX: 82-53-628-4020 E-mail: mwahn@med.yu.ac.kr

Received 12 February 2010 Revised 19 July 2011 Accepted 19 July 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retrospective study.

Objectives

This study was performed by probing vertebral artery injuries and their radiologic characteristics in cervical spine fractures, and analyzing MRI findings of vascular injuries.

Summary of Literature Review

Vertebral artery injuries are found relatively often in cervical spine fractures.

Materials and Methods

We evaluated 57 cases of cervical spine fractures that occurred beginning in June 2011 and ending in February 2003. The characteristics of each fracture were evaluated using conventional radiographs, CT, and MRI. The presence of a vertebral artery injury was based on the absence of signal void in multilevel transverse foramens.

Results

Twelve out of the 57 cases (21.1%) were found to have unilateral vertebral artery injuries. Clinically, impairment in cerebral circulation was not found.

We found no statistical correlation between the signal change in the spinal cord and in the vertebral artery injury (P=0.424). We noted fractures of transverse processes in 7 cases, 6 of which showed vertebral artery injuries. Thus, the transverse process facture was associated with t vertebral artery injury (P=0.000). There seemed to be no relationship between the vertebral artery injury and each of following: fracture level (P=0.416), fracture type (P=0.723) and severity of soft tissue injury (P=0.195).

Conclusions

Unilateral vertebral artery injuries were frequently found in the cervical spine fractures. And of all radiographic factors associated with vertebral artery injury, only the presence of transverse process fracture was statistically significant. Absence of signal void at multi-section MR images is considered to be a useful guide to commence additional vascular evaluation.

Keywords: Vertebral artery injury, Cervical spine fracture, MRI

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