Post-mortem computed tomography of cervical intervertebral separation: Retrospective review and comparison of the autopsy results of 57 separations

Objectives: The presence of an intervertebral separation indicates vertebral ligamentous injuries, and it is occasionally associated with fatal spinal cord injuries. However, it is often difficult to identify the separation using post-mortem computed tomography (CT). This study retrospectively evaluated the correlation between the post-mortem CT findings and autopsy results of cervical intervertebral separation. Materials and methods: Forty-two subjects (8 females and 34 males) with cervical intervertebral separation were evaluated. The average age was 67 (range, 29–88) years. A radiologist retrospectively reviewed the cervical spines on axial, sagittal, and coronal CT images and determined whether intervertebral separations could be detected. The radiologist also classified the CT findings in cases with detectable separations. Results: Of the 57 cervical intervertebral separations, 39 were detectable on the CT images. The CT findings were grouped into the following six categories: intervertebral gas (n = 19; 40.4%); forward intervertebral widening (n = 10; 21.3%); backward intervertebral widening (n = 1; 2.1%); anteroposterior misalignment (n = 6; 12.8%); spur fracture (n = 7; 14.9%); and hematoma in front of a vertebral body (n = 4; 8.5%). The sensitivity and specificity of intervertebral gas in the diagnosis of cervical intervertebral separation were 33.9% and 99.7%, respectively. Conclusion: Approximately 70% of the cases with cervical intervertebral separations had various abnormal findings on CT imaging. The most common finding was intervertebral gas, but the sensitivity of intervertebral gas was not adequate.