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Treatment for lateral flexion fracture dislocation of the cervical spine: report of two cases.

Shiina I, Hioki S, Kamada H, Amano K, Noguchi H - J Rural Med (2010)

Bottom Line: We were unable to obtain good reduction.We did not perform manual reduction.Since closed reduction is sometimes difficult and involves risk, strong internal fixation might be recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Ibaraki Seinan Medical Center Hospital, Japan ; Department of Orthopedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.

ABSTRACT
The injury mechanism of traumatic cervical spine injury varies, and Allen et al. divide cervical spine injuries into 6 types based on the direction of external force at the time of injury. In this report, we present 2 cases as Lateral Flexion Stage 2. A 51-year-old male (Case 1) was injured in a traffic accident. His conscious level was JCS III-200, and he was found to have a Frankel Grade of B. X-ray revealed a C5/6 fracture dislocation injury of Lateral Flexion Stage 2. We were unable to obtain good reduction. We planned to perform posterior fusion using a cervical spine pedicle screw but could not perform the procedure due to the patient's poor general condition. A 32-year-old male (Case 2) was injured as a result of being hit by a steel sheet. He had Frankel Grade D paralysis. X-ray revealed a C5/6 fracture dislocation injury of Lateral Flexion Stage 2. We did not perform manual reduction. We performed posterior fixation, anterior decompression and anterior fixation. Bone union was confirmed, and the patient was able to return to work. In cases of this type of fracture dislocation of the cervical spine, the supporting structures of the spinal column circumferentially rupture and induce high instability. Since closed reduction is sometimes difficult and involves risk, strong internal fixation might be recommended.

No MeSH data available.


Related in: MedlinePlus

Cervical spine X-ray images of case 1. On the frontal view (left), dilation of theleft facet joint at the level of C5/6 and dislocation of the C5 vertebral body tothe right side were revealed. From the lateral view (right), interspinous dilationwas observed.
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fig_002: Cervical spine X-ray images of case 1. On the frontal view (left), dilation of theleft facet joint at the level of C5/6 and dislocation of the C5 vertebral body tothe right side were revealed. From the lateral view (right), interspinous dilationwas observed.

Mentions: The subject was a 51-year-old male. He was the driver of a car involved in a collision inwhich his car was hit from the left side and overturned. He was not wearing his seatbelt,and his left parietal region was the first area of impact. His car was overturned upsidedown, and he might receive injury with his own weight being as an external strength. Onadmission, his conscious level was JCS III-200, and he inflected the right elbow inresponse to pain stimulation. Since he was in shock and was experiencing respiratoryfailure, he was intubated and treated with a ventilator. We diagnosed his injury as GradeB according to the Frankel classification. An anteroposterior plain radiograph showeddilation of the left facet joint at the level of C5/6 and dislocation of the C5 vertebralbody to the right side. A lateral plain radiograph showed interspinous dilation (Figure 2Figure 2.


Treatment for lateral flexion fracture dislocation of the cervical spine: report of two cases.

Shiina I, Hioki S, Kamada H, Amano K, Noguchi H - J Rural Med (2010)

Cervical spine X-ray images of case 1. On the frontal view (left), dilation of theleft facet joint at the level of C5/6 and dislocation of the C5 vertebral body tothe right side were revealed. From the lateral view (right), interspinous dilationwas observed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4309361&req=5

fig_002: Cervical spine X-ray images of case 1. On the frontal view (left), dilation of theleft facet joint at the level of C5/6 and dislocation of the C5 vertebral body tothe right side were revealed. From the lateral view (right), interspinous dilationwas observed.
Mentions: The subject was a 51-year-old male. He was the driver of a car involved in a collision inwhich his car was hit from the left side and overturned. He was not wearing his seatbelt,and his left parietal region was the first area of impact. His car was overturned upsidedown, and he might receive injury with his own weight being as an external strength. Onadmission, his conscious level was JCS III-200, and he inflected the right elbow inresponse to pain stimulation. Since he was in shock and was experiencing respiratoryfailure, he was intubated and treated with a ventilator. We diagnosed his injury as GradeB according to the Frankel classification. An anteroposterior plain radiograph showeddilation of the left facet joint at the level of C5/6 and dislocation of the C5 vertebralbody to the right side. A lateral plain radiograph showed interspinous dilation (Figure 2Figure 2.

Bottom Line: We were unable to obtain good reduction.We did not perform manual reduction.Since closed reduction is sometimes difficult and involves risk, strong internal fixation might be recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Ibaraki Seinan Medical Center Hospital, Japan ; Department of Orthopedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.

ABSTRACT
The injury mechanism of traumatic cervical spine injury varies, and Allen et al. divide cervical spine injuries into 6 types based on the direction of external force at the time of injury. In this report, we present 2 cases as Lateral Flexion Stage 2. A 51-year-old male (Case 1) was injured in a traffic accident. His conscious level was JCS III-200, and he was found to have a Frankel Grade of B. X-ray revealed a C5/6 fracture dislocation injury of Lateral Flexion Stage 2. We were unable to obtain good reduction. We planned to perform posterior fusion using a cervical spine pedicle screw but could not perform the procedure due to the patient's poor general condition. A 32-year-old male (Case 2) was injured as a result of being hit by a steel sheet. He had Frankel Grade D paralysis. X-ray revealed a C5/6 fracture dislocation injury of Lateral Flexion Stage 2. We did not perform manual reduction. We performed posterior fixation, anterior decompression and anterior fixation. Bone union was confirmed, and the patient was able to return to work. In cases of this type of fracture dislocation of the cervical spine, the supporting structures of the spinal column circumferentially rupture and induce high instability. Since closed reduction is sometimes difficult and involves risk, strong internal fixation might be recommended.

No MeSH data available.


Related in: MedlinePlus