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椎体前下角骨折，即泪滴骨折：是一种复杂、严重的损伤，需要正确诊断及治疗。这种损伤的特征是椎体冠状面的前下角的骨折和椎体矢状面上的后半部分骨折(并不常见)；可同时存在椎间盘破裂、后方韧带断裂和/或同一水平或相邻水平的后柱骨性结构骨折。Korres等根据前下角骨折碎片的大小和椎体后部移位至椎管的情况，将其分为四种类型：Type I is characterized by a small fracture of the anterior inferior angle of the vertebral body (its size is less than 3mm) without the presence of a sagittal fracture of the posterior half of the body and without retrolisthesis. There is a disruption of the posterior ligamentous elements.
Type II is characterized by a coronal fracture of the anterior inferior angle of the vertebral body and a sagittal fracture of the posterior half of the vertebral body (as discribed by Fuentes, but without posterior displacement of the involved vertebral body.Type III is divided in two subtypes (a and b) according to the retrolisthesis of the vertebral body (or of its fragments) visible on the initial lateral view. If the displacement is greater than 4 mm, the injury is classified as type IIIb, otherwise as type IIIa .Type IV represents a fracture of the anterior inferior angle of the vertebral body associated with a locked facet and anterior dislocation of the vertebra above .
Fig,1. Type I: a 'tear drop' fracture of C3 ( → ) . Note the disturbance at the joint (white arrow on the right) and the prevertebral swelling (arrows on the left) Fig.2. Type II: 'tear drop' fracture. There is no posterior displacement of the fractured vertebral body Fig.3. Type IIIa: 'tear drop' fractures of two contiguous vertebrae. Posterior displacement of less than 4 mm of the fractured body of the proximal (C5) vertebra Fig.4. Type IIIb: 'tear drop' fracture of C6. Posterior displacement of the vertebral body of more than 4 mm Fig.5. Type IV: 'tear drop' fracture of C5 with dislocation of the superior vertebra
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