Abstract
Fracture of the articular process of a cervical vertebra has received little attention in the literature. This fracture is often overlooked because only a very subtle change is shown in conventional radiological examinations.
In this review of 26 patients with cervical vertebra trauma examined with a high resolution computed tomography (CT) scanner (Somatom II) in the past 3 years, the authors found 6 cases with fracture of the articular process of a cervical vertebra. The diagnosis was mainly based on the very useful findings of CT scan. On the other hand, the plain neck films had less diagnostic value. Some indirect signs, however, such as an anterior subluxation and narrowing of the intervertebral foramen revealed in the plain neck films seemed valuable. The clinical symptoms of this fracture consisted of radicular injury and persistent neck pain. Hyperflexion injury, which seemed to be a notable tendency, was considered as a possible mechanism of this fracture in 2 cases. Anterior fusion was performed in 3 cases and in 3 other cases conservative therapy was continued.
A therapeutic policy for this fracture has not been established. The authors emphasize that both anterior fusion and the removal of the fractured fragment are necessary when anterior subluxation is obvious and the fractured fragment has caused the radicular injury.
