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Sagittal fractures of III-VI cervical vertebral bodies: causes, symptoms, diagnosis, treatment
Medical expert of the article
Last reviewed: 05.07.2025
Sagittal, or vertical, fractures of the cervical vertebrae are a special, rare type of compression comminuted fractures of the cervical vertebrae.
They are found only at the level of the III - VI cervical vertebrae, i.e. along the length at which the bodies of the cervical vertebrae can occupy a vertical position, be in a position between kyphosis and lordosis.
[ What causes sagittal fractures of the bodies of the III-VI cervical vertebrae?
Sagittal fractures occur when violence is applied vertically through the vertebral bodies. It is not clear why typical compression comminuted fractures occur more often and sagittal fractures occur much less often with the same mechanism of violence.
Morlaechi and Garosi (1964) tried to find out experimentally the reason for the occurrence of sagittal fractures on an acrylic model of cervical vertebrae in polarized light when exposed to axial force. The authors noted that it was quite difficult to reproduce a strictly vertical load on the model of cervical vertebrae in the experiment, but when this was possible, a sagittal fracture occurred.
According to Nielsen (1965), only 25 cases of sagittal fractures of the cervical vertebrae have been described in the literature. The author supplemented these cases with his own single case.
Sagittal fractures of the cervical vertebral bodies usually occur in adults, which some authors (Morlaechi, Garosi, 1964) explain by age-related degenerative changes in the spine, leading to the elimination of physiological cervical lordosis. The cause of sagittal fractures of the cervical vertebral bodies is the inability of the "dried" intervertebral disc to exert a hydrostatic effect, causing a comminuted compression fracture.
Symptoms of sagittal fractures of the cervical vertebrae
Symptoms of sagittal fractures of the cervical vertebrae are rather poor and are often limited to minor local pain. Most often, these fractures are detected radiologically. In 3 of 4 victims observed by Morlaechi and Garosi, sagittal fractures were detected as an incidental radiographic finding. The posterior spondylogram is decisive in diagnosis, as it reveals a vertical fracture line running in the sagittal plane through the entire thickness of the vertebral body, dividing the vertebral body into two halves without reducing its height.
Treatment of sagittal fractures of the cervical vertebrae
Treatment of sagittal fractures of the cervical vertebrae consists of immobilization with a plaster cast. If it is impossible to immediately apply a cast, skeletal traction is applied first.