Clinical algorithm for preventing missed diagnoses of occult cervical spine instability after acute trauma: A case report

Figure 1 A case of occult cervical spine instability. A: The standard lateral X-ray at admission showed no obvious instability of the cervical spine; B: The magnetic resonance imaging at admission showed injuries involving the disc (orange arrow) and posterior interspinous ligament (yellow arrows) at the C5-6 level; C: The intraoperative C-arm fluoroscopic X-ray after anesthesia and muscle relaxation revealed significantly increased intervertebral space at C5-6, indicating instability at this level.

Figure 2 Clinical algorithm for diagnosing occult cervical spine instability. CT: Computed tomography; MRI: Magnetic resonance imaging.