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Traumatic cervical cord transection without facet dislocations--a proposal of combined hyperflexion-hyperextension mechanism: a case report.

Cha YH, Cho TH, Suh JK - J. Korean Med. Sci. (2010)

Bottom Line: Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine.A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported.Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
A patient is presented with a cervical spinal cord transection which occurred after a motor vehicle accident in which the air bag deployed and the seat belt was not in use. The patient had complete quadriplegia below the C5 level and his imaging study showed cervical cord transection at the level of the C5/6 disc space with C5, C6 vertebral bodies and laminar fractures. He underwent a C5 laminectomy and a C4-7 posterior fusion with lateral mass screw fixation. Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine. A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported. Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.

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Related in: MedlinePlus

C5 and C6 wedge compression fractures with minimal C5 retrolisthesis on C6 are revealed on a plain lateral cervical film, but there is no evidence of dislocation of the facet joints.
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Figure 1: C5 and C6 wedge compression fractures with minimal C5 retrolisthesis on C6 are revealed on a plain lateral cervical film, but there is no evidence of dislocation of the facet joints.

Mentions: Plain radiographic evaluation of his cervical spine showed C5, C6 wedge compression fractures and minimal C5 retrolisthesis on C6 (Fig. 1). A computed tomographic (CT) scan also demonstrated C5, C6 vertebral body vertical fractures with laminar fractures, and a C3 spinous process fracture (Fig. 2). The fractured C5 lamina was depressed into the spinal canal through the lamina-facet junctions. The C5/6 facet joints were intact. A MRI revealed a linear area of abnormal signal intensity running horizontally through the spinal cord at the C5-6 disc space level, which was thought to represent a spinal cord transaction (Fig. 3). The patient had no brain, thoracic, or abdominal abnormalities on plain films and CT scans.


Traumatic cervical cord transection without facet dislocations--a proposal of combined hyperflexion-hyperextension mechanism: a case report.

Cha YH, Cho TH, Suh JK - J. Korean Med. Sci. (2010)

C5 and C6 wedge compression fractures with minimal C5 retrolisthesis on C6 are revealed on a plain lateral cervical film, but there is no evidence of dislocation of the facet joints.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908802&req=5

Figure 1: C5 and C6 wedge compression fractures with minimal C5 retrolisthesis on C6 are revealed on a plain lateral cervical film, but there is no evidence of dislocation of the facet joints.
Mentions: Plain radiographic evaluation of his cervical spine showed C5, C6 wedge compression fractures and minimal C5 retrolisthesis on C6 (Fig. 1). A computed tomographic (CT) scan also demonstrated C5, C6 vertebral body vertical fractures with laminar fractures, and a C3 spinous process fracture (Fig. 2). The fractured C5 lamina was depressed into the spinal canal through the lamina-facet junctions. The C5/6 facet joints were intact. A MRI revealed a linear area of abnormal signal intensity running horizontally through the spinal cord at the C5-6 disc space level, which was thought to represent a spinal cord transaction (Fig. 3). The patient had no brain, thoracic, or abdominal abnormalities on plain films and CT scans.

Bottom Line: Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine.A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported.Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
A patient is presented with a cervical spinal cord transection which occurred after a motor vehicle accident in which the air bag deployed and the seat belt was not in use. The patient had complete quadriplegia below the C5 level and his imaging study showed cervical cord transection at the level of the C5/6 disc space with C5, C6 vertebral bodies and laminar fractures. He underwent a C5 laminectomy and a C4-7 posterior fusion with lateral mass screw fixation. Previous reports have described central cord syndromes occurring in hyperextension injuries, but in adults, acute spinal cord transections have only developed after fracture-dislocations of the spine. A case involving a post-traumatic spinal cord transection without any evidence of radiologic facet dislocations is reported. Also, we propose a combined hyperflexion-hyperextension mechanism to explain this type of injury.

Show MeSH
Related in: MedlinePlus