The significance of prevertebral soft tissue swelling in extension teardrop fracture of the cervical spine

Abstract

The purpose of this study was to assess the relationship of prevertebral soft tissue (PVST) swelling and cervical spinal cord injury in extension teardrop fracture (ETF). Cervical spine radiographs and the clinical courses of 36 adult patients who sustained extension teardrop fracture(s) were reviewed retrospectively. Radiographic and neurologic findings were correlated. Thirty-two of 36 patients (89%) showed no evidence of cervical spinal cord injury throughout their clinical course, whereas 4 of 36 patients (11%) had a cervical myelopathy. In 30 patients with ETF and in whom the PVST shadow could be assessed, 7 (23%) had minimal or no PVST swelling, 18 (60%) had focal swelling, and 5 (17%) had diffuse/marked PVST swelling. Of the patients with ETF and no, minimal, or focal PVST swelling, none had cervical myelopathy. Four of 5 patients (80%) with ETF and diffuse/marked PVST and/or prior endotracheal intubation had cervical myelopathy. We conclude that diffuse/marked PVST swelling, or prior endotracheal intubation, was significantly associated with cervical spinal cord injury (P<0.05). There was no statistically significant correlation between minimal or focal PVST swelling and spinal cord injury.