{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:56:37Z","timestamp":1772103397218,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004324","name":"Astellas Pharma Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004324","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100023368","name":"Eisai Co., Ltd.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023368","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Pfizer Japan Inc."},{"name":"SHIONOGI Co., Ltd."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Magnetic resonance imaging (MRI) is effective in identifying cervical spine injury after trauma. However, cervical instability without major bone injury or dislocation is challenging to assess. Hence, the current study aimed to investigate and compare the MRI and radiography findings of segmental instability in patients with cervical spine injury. We investigated 34 participants with cervical spine injury without vertebral fracture. Based on the radiography findings, the participants were categorized into two: group A with segmental instability (n\u2009=\u200911) and group B without segmental instability (n\u2009=\u200923). Both groups were compared in terms of the presence of segmental instability on radiography and MRI. Anterior longitudinal ligament (ALL) injury, disc injury, and bilateral facet effusion were observed in\u00a06\/11, 5\/11, and 7\/11 patients in group A and in\u00a05\/23, 2\/23 and\u00a07\/23 patients in group B, respectively. The results showed significant differences (p\u2009&lt;\u20090.05). Moreover, 2 and 10 of 11 patients in group A and 16 and 7 of 23 patients in group B presented with hemi lateral facet effusion and paravertebral muscle injury, respectively. However, the results did not significantly differ. According to a logistic regression analysis, bilateral facet effusion after trauma was associated with cervical segmental instability (odd ratio: 10.6, 95% confidence interval: 1.31\u201384.7). Facet joint effusion might be caused by capsule injury during trauma. Most participants with segmental instability had ALL, disc, and flavum injury and bilateral facet effusion. Therefore, we need to consider bilateral facet effusion with other soft tissue damage of the cervical spine as an association factor to show the instability.<\/jats:p>","DOI":"10.1038\/s41598-021-91981-y","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T10:04:25Z","timestamp":1623751465000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bilateral facet effusion is a risk factor for segmental instability with cervical injury without vertebral fracture"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8137-4658","authenticated-orcid":false,"given":"Shinji","family":"Tanishima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tokumitsu","family":"Mihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikako","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Nagashima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"issue":"3","key":"91981_CR1","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.surneu.2004.05.042","volume":"63","author":"MK Tewari","year":"2005","unstructured":"Tewari, M. K. et al. Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: Analysis of 40 patients. Surg. Neurol. 63(3), 204\u2013209. https:\/\/doi.org\/10.1016\/j.surneu.2004.05.042 (2005) (discussion 209).","journal-title":"Surg. Neurol."},{"issue":"15","key":"91981_CR2","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1097\/00007632-200208010-00011","volume":"27","author":"Y Ishida","year":"2002","unstructured":"Ishida, Y. & Tominaga, T. Predictors of neurologic recovery in acute central cervical cord injury with only upper extremity impairment. Spine 27(15), 1652\u20131658. https:\/\/doi.org\/10.1097\/00007632-200208010-00011 (2002) (discussion 1658).","journal-title":"Spine"},{"issue":"4","key":"91981_CR3","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jocn.2004.04.008","volume":"12","author":"J Song","year":"2005","unstructured":"Song, J., Mizuno, J., Nakagawa, H. & Inoue, T. Surgery for acute subaxial traumatic central cord syndrome without fracture or dislocation. J. Clin. Neurosci. 12(4), 438\u2013443. https:\/\/doi.org\/10.1016\/j.jocn.2004.04.008 (2005).","journal-title":"J. Clin. Neurosci."},{"issue":"6","key":"91981_CR4","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.surneu.2004.09.037","volume":"63","author":"J Uribe","year":"2005","unstructured":"Uribe, J. et al. Acute traumatic central cord syndrome\u2014experience using surgical decompression with open-door expansile cervical laminoplasty. Surg. Neurol. 63(6), 505\u2013510. https:\/\/doi.org\/10.1016\/j.surneu.2004.09.037 (2005) (discussion 510).","journal-title":"Surg. Neurol."},{"issue":"25","key":"91981_CR5","doi-asserted-by":"publisher","first-page":"E1560","DOI":"10.1097\/BRS.0b013e318272f345","volume":"37","author":"T Maeda","year":"2012","unstructured":"Maeda, T. et al. Soft-tissue damage and segmental instability in adult patients with cervical spinal cord injury without major bone injury. Spine 37(25), E1560\u2013E1566. https:\/\/doi.org\/10.1097\/BRS.0b013e318272f345 (2012).","journal-title":"Spine"},{"key":"91981_CR6","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/00003086-197506000-00011","volume":"109","author":"AA White 3rd","year":"1975","unstructured":"White, A. A. 3rd., Johnson, R. M., Panjabi, M. M. & Southwick, W. O. Biomechanical analysis of clinical stability in the cervical spine. Clin. Orthop. Relat. Res. 109, 85\u201396 (1975).","journal-title":"Clin. Orthop. Relat. Res."},{"issue":"1","key":"91981_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-198200710-00001","volume":"7","author":"BL Allen Jr","year":"1982","unstructured":"Allen, B. L. Jr., Ferguson, R. L., Lehmann, T. R. & O\u2019Brien, R. P. A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine 7(1), 1\u201327 (1982).","journal-title":"Spine"},{"issue":"3","key":"91981_CR8","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.spinee.2017.08.231","volume":"18","author":"T Thesleff","year":"2018","unstructured":"Thesleff, T. et al. Preventable diagnostic errors in fatal cervical spine injuries: A nationwide register-based study from 1987 to 2010. Spine J. 18(3), 430\u2013438. https:\/\/doi.org\/10.1016\/j.spinee.2017.08.231 (2018).","journal-title":"Spine J."},{"issue":"5","key":"91981_CR9","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1111\/j.1365-2044.2004.03666.x","volume":"59","author":"CG Morris","year":"2004","unstructured":"Morris, C. G. & McCoy, E. Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening. Anaesthesia 59(5), 464\u2013482. https:\/\/doi.org\/10.1111\/j.1365-2044.2004.03666.x (2004).","journal-title":"Anaesthesia"},{"issue":"6","key":"91981_CR10","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1097\/00005373-200106000-00011","volume":"50","author":"JW Davis","year":"2001","unstructured":"Davis, J. W. et al. Routine evaluation of the cervical spine in head-injured patients with dynamic fluoroscopy: A reappraisal. J. Trauma 50(6), 1044\u20131047 (2001).","journal-title":"J. Trauma"},{"issue":"1","key":"91981_CR11","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1067\/mem.2001.116810","volume":"38","author":"CV Pollack Jr","year":"2001","unstructured":"Pollack, C. V. Jr. et al. Use of flexion-extension radiographs of the cervical spine in blunt trauma. Ann. Emerg. Med. 38(1), 8\u201311. https:\/\/doi.org\/10.1067\/mem.2001.116810 (2001).","journal-title":"Ann. Emerg. 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