This is a flexion teardrop fracture – the mechanism of injury is hyperflexion and axial compression. It is associated with anterior and posterior ligamentous tears, injury to the ligamentum flavum, and posterior subluxation. It is generally seen in C4-C6 .
Pearl: Four lines can be drawn to assist in reading cervical spine x-rays and CTs (Figure 2). These include the anterior vertebral, posterior vertebral, spinolaminar, and posterior spinous lines. Note that all four are disrupted in Figure 1.
A flexion teardrop fracture is most commonly associated with anterior cord syndrome . This syndrome presents as loss of movement and pain/temperature below the level of the lesion with preservation of the dorsal columns (vibration, proprioception, and 2-point discrimination).