Cervical spine computed tomography motion artifact mimicking spine injury in a patient with severe head injury

BACKGROUND: Craniocervical CT scan is an essential part of the routine evaluation of patient with moderate and severe head injury to rule out associated cervical spine injury. Computed tomography motion artifacts can affect clinical decision making. The aim of this report is to emphasize that motion artifact still exists despite advance in technology and this can pose clinical challenge. CASE DESCRIPTION: A 20-year-old man presented to our facility with severe head injury GCS 8. Craniocervical CT scan reported 75% C3 on C4 anterior subluxation and urgent spinal stabilization surgery was recommended. A static lateral cervical spine X-ray showed normal bony alignment. He was successfully managed and dynamic studies after recovery were normal. CONCLUSION: Cervical spine CT motion artifact can lead to unneeded surgery but routine clinical evaluation and cervical spine static and dynamic X-rays may be sufficient to resolve the puzzle.