Floating vertebra sign and teardrop sign.Sagittal CT cervical spine of a 77-year-old man following a high energy motor vehicle accident shows 100% translation of the C6 on C7 vertebral bodies, which is consistent with a grade IV anterolisthesis. The appearance of a “floating vertebra” (upward pointing arrow) is associated with bilateral facet joint dislocation and injury to the posterior ligamentous complex. In addition, there are fractures involving the C5 and C6 spinous processes (double head arrow). The mechanism of injury is secondary to forceful muscle contraction, transmitted through the supraspinous ligaments. The tremendous contraction force produces the avulsion fractures of the spinous process known as clay-shoveler fracture. Note the presence of a tiny anterior “teardrop” fracture at the anterior and inferior aspect of the C6 vertebral body (arrow head).