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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

Post-operative cervical spine X-ray images of case 2. Anterior and posteriorfixation with autologous bone grafts were performed.
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fig_006: Post-operative cervical spine X-ray images of case 2. Anterior and posteriorfixation with autologous bone grafts were performed.

Mentions: Reduction by traction was not performed, and immobilization in a halo vest was applied onthe day after injury. The mandible contusion was cured without deep infection, and fusionwas performed 2 weeks after the injury. With the patient wearing the halo vest in a proneposition, the posterior approach was performed. Among the posterior supporting structures,the supraspinous and interspinal ligaments and left C5/6 facet joint capsule were rupturedand remarkably unstable. After reduction, an autologous bone was grafted between spinousprocesses and was fastened with polyethylene tape. We performed anterior decompression andfixation with the patient in the supine position (Figure 6Figure 6.


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)

Post-operative cervical spine X-ray images of case 2. Anterior and posteriorfixation with autologous bone grafts were performed.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig_006: Post-operative cervical spine X-ray images of case 2. Anterior and posteriorfixation with autologous bone grafts were performed.
Mentions: Reduction by traction was not performed, and immobilization in a halo vest was applied onthe day after injury. The mandible contusion was cured without deep infection, and fusionwas performed 2 weeks after the injury. With the patient wearing the halo vest in a proneposition, the posterior approach was performed. Among the posterior supporting structures,the supraspinous and interspinal ligaments and left C5/6 facet joint capsule were rupturedand remarkably unstable. After reduction, an autologous bone was grafted between spinousprocesses and was fastened with polyethylene tape. We performed anterior decompression andfixation with the patient in the supine position (Figure 6Figure 6.

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