Non-fatal injuries to the cervical spine facet joints after a fatal motor vehicle crash: a case report

• Published in: Medicine, science, and the law science, and the law, 2009-07, Vol.49 (3), p.218-221
• Main Authors: Uhrenholt, Lars, Nielsen, Edith, Charles, Annie Vesterby, Gregersen, Markil
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Cervical Vertebrae - injuries; Cervical Vertebrae - pathology; Diagnostic Imaging; Forensic Pathology; Humans; Male; Microscopy; Middle Aged; Zygapophyseal Joint - injuries; Zygapophyseal Joint - pathology
• ISSN: 0025-8024
• DOI: 10.1258/rsmmsl.49.3.218

Injuries to the lower cervical spine facet joints may be identified in people killed in road traffic crashes. However, many of these injuries are not identified on diagnostic imaging procedures despite histological evidence of injury. This case report illustrates possible non-lethal pathological conditions in the facet joints following fatal road traffic trauma. The cervical spine segments C4 to C7 were removed en bloc and examined with magnetic resonance imaging, computed tomography and conventional radiology. The specimen was fixated in alcohol, embedded in methylmethacrylate, and divided into 3 mm thick parasaggital slices from where 10 microm thick sections were produced and evaluated with light microscopy. Injuries identified on microscopy included haemarthrosis, capsular avulsion, synovial fold contusions and subchondral fractures. None of the injuries were detected on diagnostic imaging or at routine autopsy. Discrete injuries to the cervical spine facet joints were identified using supplemental histological procedures in this case report. Post-mortem diagnostic imaging did not reveal these injuries and future studies should investigate the nature, prevalence and clinical relevance of such lesions.