Limits...
Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review.

Wong AS, Yu DH - Asian J Neurosurg (2015 Jan-Mar)

Bottom Line: He went back to full employment.Good outcome can be achieved by early diagnosis and treatment.This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia.

ABSTRACT
Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

No MeSH data available.


Related in: MedlinePlus

Immediate postoperative lateral cervical spine X-ray
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4352639&req=5

Figure 4: Immediate postoperative lateral cervical spine X-ray

Mentions: Laminectomies were done at the cervical, cervicothoracic and thoracic levels to evacuate the epidural hematoma. Size 8 feeding tube was used to flush out the hematoma in between the areas of the laminotomies. Lateral mass plates were used to fix the spine from C3 to C5. He was put on a cervical collar. Two hours after the operation he regained full strength in all the limbs while he was in the Intensive Care Unit. However a week later he developed a posterior wound infection on the 1/2/2009. He was treated with antibiotics and wound dressing. Ten days later he had an anterior C4 corpectomy with C3-C5 fixation and fusion. The autologous iliac bone graft was placed between the superior and the inferior end plates of C4. The immediate postoperative X-ray is shown in Figure 4 (immediate postoperative lateral cervical spine X-ray). His posterior wound was treated with secondary suturing at the same time. He was able to walk with a walking frame on the 18/2/2009 and the urinary catheter was removed on the next day. He was discharged from the hospital on the 22/2/2009. Subsequently, he went back to his normal work.


Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review.

Wong AS, Yu DH - Asian J Neurosurg (2015 Jan-Mar)

Immediate postoperative lateral cervical spine X-ray
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352639&req=5

Figure 4: Immediate postoperative lateral cervical spine X-ray
Mentions: Laminectomies were done at the cervical, cervicothoracic and thoracic levels to evacuate the epidural hematoma. Size 8 feeding tube was used to flush out the hematoma in between the areas of the laminotomies. Lateral mass plates were used to fix the spine from C3 to C5. He was put on a cervical collar. Two hours after the operation he regained full strength in all the limbs while he was in the Intensive Care Unit. However a week later he developed a posterior wound infection on the 1/2/2009. He was treated with antibiotics and wound dressing. Ten days later he had an anterior C4 corpectomy with C3-C5 fixation and fusion. The autologous iliac bone graft was placed between the superior and the inferior end plates of C4. The immediate postoperative X-ray is shown in Figure 4 (immediate postoperative lateral cervical spine X-ray). His posterior wound was treated with secondary suturing at the same time. He was able to walk with a walking frame on the 18/2/2009 and the urinary catheter was removed on the next day. He was discharged from the hospital on the 22/2/2009. Subsequently, he went back to his normal work.

Bottom Line: He went back to full employment.Good outcome can be achieved by early diagnosis and treatment.This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia.

ABSTRACT
Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

No MeSH data available.


Related in: MedlinePlus