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©2013 UpToDate ® Print Email Bilateral laminar fractures of cervical spine Lateral radiograph (A) demonstrates posterior impaction with multiple comminuted laminar and spinous processes fractures from C2 to C6 (white arrows). The acute vacuum disc (black arrow) with abnormal widening of the anterior C6-7 disc space is a sign of anterior and middle column distraction. The corresponding CT images (B and C) demonstrate displacement of the spinous processes and bilateral comminuted laminar fractures (white arrows). Reproduced with permission from: Schwartz ED, Flander AE. Spinal Trauma: Imaging, Diagnosis, and Management, Lippincott Williams & Wilkins, Philadelphia 2007. Copyright © 2007 Lippincott Williams & Wilkins.