Introduction A retrospective survey of the admission records of three Australian Spinal Injury Units was combined with review of the Western Australian Spinal Cord Neurotrauma database to quantify incidence and patterns of spinal trauma within the cervicothoracic junctional [CTJ] region.

Methods Cases involving fracture and/or dislocation within the C6 to T4 region from three Australian Spinal Injury Units and the WA Spinal Cord Neurotrauma database were analysed, with particular reference to C7-T1 segmental trauma. Mechanism of injury, radiological features and neurological status were recorded.

Results Four hundred and one cases from three Australian Spinal Injury Units were reviewed. Trauma at C7-T1 occurred in 32 [0.8 percent] of all spinal admissions assessed, most commonly resulting in an anterior dislocation of C7 on T1. Where permanent neurological status was recorded, 64 percent were complete and 32 percent partial lesions. Most frequently cases involved 20 to 29 year old males and injury typically resulted from motor cycle accidents (44%) followed by motor vehicle accidents (31%). Of the 596 spinal injury cases resulting in fatality recorded in a State based Neurotrauma database, fracture / dislocation of the C7/T1 junction occurred in 1.3 percent.

Discussion Fracture and / or dislocation within the cervicothoracic junctional region is rare, often involve young males who present following serious motor vehicle accidents. The injury frequently results in significant neurological compromise.