Vargas-Mena R, Dufoo-Olvera M, García-López OF, López-Palacios JJ, Aburto-Trejo JA, Capiz-Ruiz ER

Language: Spanish
References: 16
Page: 315-318
PDF size: 356.24 Kb.

ABSTRACT

Introduction: Multiple cervical spine fractures are a relatively infrequent entity and thus the available information on them is scarce worldwide. The cases reported are usually managed conservatively, with a combination of skeletal traction and various braces, with variable results. There are only a few reports of multiple fractures treated surgically. Objective: This is a report of a clinical case of a multiple cervical fracture treated surgically in 2 stages at the Mexico City Center for Patients with Spine and Spinal Cord Injury (Centro de Atención a Lesionados Raquimedulares de la Ciudad de México), located at «La Villa» General Hospital, SSDF. Material and methods: We report the clinical case of a male, 46 year-old patient involved in a motor vehicle accident who sustained spine and spinal cord injuries consisting of ASIA C C2-C6 fractures. It was decided to perform two-stage surgery with posterior and anterior instrumentation. We report the 19-month clinical and radiological follow-up. Results: In the 19-month follow-up visit, the patient was found to be ASIA D according to the neurological assessment, with mild motor deficit of the left thoracic limb. The patient had returned to his usual job and had acceptable cervical spine mobility. Conclusions: The patient’s appropriate course from the neurological perspective and his return to his daily activities leads to recommending the surgical management of multiple fractures, customizing it in each case according to the fractures’ characteristics. Favorable results may be expected from this approach.

REFERENCES

1. Letts M, Davidson D, Healy D: Simultaneous fracture of every cervical vertebra. A case study. Spine. 2002; 27(20): E446-50.

2. Bucholz RD, Cheung KC: Halo vest versus spinal fusion for cervical injury: evidence from an outcome study. J Neurosurg. 1989; 70: 884-92.

3. Phipatanakul W, Minster G: Fractures of the second through the fifth cervical vertebra with multilevel bilateral pedicle involvement: a case report. J Bone Joint Surg Am. 2003; 85: 1347-50.

4. Tannoury T, Zmurko M, Tannoury CH, Anderson G, Chan D: Multiple unstable cervical fractures with cord compromise treated nonoperatively. A case report. Spine. 2006; 28(11): E234-8.

5. Gleizes V, Jacquot FP, Signoret F, et al: Combined injuries in the upper cervical spine: clinical and epidemiological data over a 14-year period. Eur Spine J. 2000; 9: 386-92.

6. Vaccaro AR, An HS, Lin S, et al: Noncontiguous injuries of the spine. J Spinal Disord. 1992; 5: 320-9.

7. Iencean SM: Double noncontiguous cervical spinal injuries. Acta Neurochir (Wien). 2002; 144: 695-701.

8. Li F, Chen Q, Xu K: The treatment of concomitant odontoid fracture and lower cervical spine injuries. Spine. 2008; 33(19): E693-8.

9. Letts M, Davidson D, Healy D: Simultaneous fracture of every cervical vertebra. A case study. Spine. 2002; 27(20): E446-50.

10. Bucholz RD, Cheung KC: Halo vest versus spinal fusion for cervical injury: evidence from an outcome study. J Neurosurg. 1989; 70: 884-92.

11. Phipatanakul W, Minster G: Fractures of the second through the fifth cervical vertebra with multilevel bilateral pedicle involvement: a case report. J Bone Joint Surg Am. 2003; 85: 1347-50.

12. Tannoury T, Zmurko M, Tannoury CH, Anderson G, Chan D: Multiple unstable cervical fractures with cord compromise treated nonoperatively. A case report. Spine. 2006; 28(11): E234-8.

13. Gleizes V, Jacquot FP, Signoret F, et al: Combined injuries in the upper cervical spine: clinical and epidemiological data over a 14-year period. Eur Spine J. 2000; 9: 386-92.

14. Vaccaro AR, An HS, Lin S, et al: Noncontiguous injuries of the spine. J Spinal Disord. 1992; 5: 320-9.

15. Iencean SM: Double noncontiguous cervical spinal injuries. Acta Neurochir (Wien). 2002; 144: 695-701.

16. Li F, Chen Q, Xu K: The treatment of concomitant odontoid fracture and lower cervical spine injuries. Spine. 2008; 33(19): E693-8.