Fig 1.

Case 2. Fracture of the anterior C7 vertebral body and posterior C6 vertebral body with traumatic spondylolisthesis (C6 on C7), tearing of the anterior and posterior longitudinal ligaments. The fracture line extended posteriorly through the C5–C6 facet, to the C3–C5 spinous processes, and involved all 3 spinal columns but at different levels.

A, Conventional radiograph of the cervical spine 16 days after trauma, showing ossification of the ALL due to AS. The distance between the posterior border of the C6 vertebral body (black arrowhead) and the spinolaminar line of C6 (black arrow) is increased, which indicates a fracture of the C6 pedicles bilaterally. There are also fractures in C3–C5 spinous processes (white arrows).

B, T1-weighted image 29 days after trauma, showing the hypointense ligament tears in the posterior column (white arrow) and in C3–C5 spinous process (black arrows). Discontinuity of the normally dark posterior longitudinal ligament at C6–C7 indicates tearing of this ligament (arrowhead).

C, T2-weighted image 29 days after trauma. The ligament tears in the posterior column (white arrow) and the fracture in the spinous process (black arrows) are hypointense. Slight hyperintense dots inside the hypointense area are the displaced spinous processes and fat-containing structures.