A 20 yo F presents to the ED following a restrained driver MVC where she struck a tree. She is awake and alert, hemodynamically stable, and complaining of no sensation from the nipple line down. She has decreased strength in her upper extremities and cannot move her lower extremities.  A CT scan is obtained. What's the diagnosis? (scroll down for answer)

Answer: Burst fracture of C7 with retropulsion

• Type of compression fracture that results from high energy axial load, typically fall from height or MVC
• Results in disruption of the posterior vertebral body cortex and retropulsion into the spinal canal
• May see associated spinal cord contusion, which is best imaged w/ MRI
• Requires emergent neurosurgical/orthopedic consult and rapid decompression of the spine