Dislocation of the Cervical Spine

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A 22-year-old man presented with a 10-day history of torticollis. Two months before presentation, he had fallen from standing height but did not report subsequent cervical pain, weakness, or paresthesia. On examination, there was a reduced range of movement of the cervical spine without other neurologic deficits. Radiography of the cervical spine showed a marked reversal of the cervical lordosis, anterior displacement of 60% of C4 on C5, anterior callus formation, bilateral facet dislocation, and increased posterior interspinous distance (double arrow) (Panel A). Magnetic resonance imaging was performed. Sagittal T2-weighted imaging revealed a spinal cord angulation with mild . . .