scholarly journals Emergency Closed Reduction of a C4/5 Fracture Dislocation with Complete Paraplegia Resulting in Profound Neurologic Recovery

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Christian W. Müller ◽  
Sebastian Decker ◽  
Roland Thietje ◽  
Christian Krettek

Introduction. Cervical spinal cord injuries due to traumatic fractures are associated with persistent neurological deficits. Although clinical evidence is weak, early decompression, defined as <24–72 h, has been frequently proposed. Animal studies show better outcomes after early decompression within one hour or less, which can hardly ever be achieved in clinical practice.Case Presentation. A 37-year-old patient was hospitalized after being hit by a shying horse. After diagnosis of C4/5 fracture dislocation and complete paraplegia, she was intubated and sedated with deep relaxation. Emergency reduction was performed at approximately 120 minutes after trauma. Subsequently, a standard anterior decompression, discectomy, and fusion were carried out. She was then transferred to a specialized rehabilitation hospital. Her neurologic function improved from AIS grade A on admission to grade B postoperatively and grade D after four months of rehabilitation. One year after the accident, she was ambulatory without walking aids and restarted horse riding.Discussion and Conclusion. Rarely in clinical practice, decompression of the spine canal can be performed as early as in this case. This case highlights the potential benefit of utmost early reduction in cervical fracture dislocations with compression of the spinal cord.

Radiology ◽  
1978 ◽  
Vol 129 (3) ◽  
pp. 707-711 ◽  
Author(s):  
Jin S. Leo ◽  
R. Thomas Bergeron ◽  
Irvin I. Kricheff ◽  
M. Vallo Benjamin

2015 ◽  
Vol 15 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Monica Salazar Davern ◽  
Sumeet Garg ◽  
Todd C. Hankinson

This report describes the presentation and operative treatment of a 3-year-old boy who survived a motor vehicle accident that resulted in a C6–7 distraction injury, complete avulsion of the spinal cord, and gross spinal instability. Only 5%–10% of all spinal cord and vertebral column injuries occur in children. Survival after such an injury is exceptionally rare in very young patients and is associated with severe neurological deficits. The authors discuss the substantial ethical challenges involved in the care of a patient with this injury. To their knowledge, only two other cases of survival have been reported in pediatric patients following motor vehicle trauma resulting in complete injury to the lower cervical spinal cord.


Author(s):  
Han Ting Wang ◽  
David Williamson ◽  
Mary Francispillai ◽  
Andréanne Richard-Denis ◽  
Martin Albert

2017 ◽  
Vol 13 (8) ◽  
pp. 724-730
Author(s):  
Bethany Hooper ◽  
Michele Verdonck ◽  
Delena Amsters ◽  
Michelle Myburg ◽  
Emily Allan

1985 ◽  
Vol 34 (1) ◽  
pp. 284-288
Author(s):  
Motofumi Komori ◽  
Kunio Sasaki ◽  
Keiichiro Shiba ◽  
Koichiro Yamano ◽  
Takayoshi Ueta ◽  
...  

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. 930-941 ◽  
Author(s):  
Yiyan Zheng ◽  
Yi Ping Zhang ◽  
Lisa B E Shields ◽  
Yongjie Zhang ◽  
Marcus W Siu ◽  
...  

2015 ◽  
Vol 06 (04) ◽  
pp. 481-487 ◽  
Author(s):  
Srinivasu Kallakuri ◽  
Heena S. Purkait ◽  
Satya Dalavayi ◽  
Pamela VandeVord ◽  
John M. Cavanaugh

ABSTRACT Introduction: Blast induced neurotrauma has been the signature wound in returning soldiers from the ongoing wars in Iraq and Afghanistan. Of importance is understanding the pathomechansim(s) of blast overpressure (OP) induced axonal injury. Although several recent animal models of blast injury indicate the neuronal and axonal injury in various brain regions, animal studies related to axonal injury in the white matter (WM) tracts of cervical spinal cord are limited. Objective: The purpose of this study was to assess the extent of axonal injury in WM tracts of cervical spinal cord in male Sprague Dawley rats subjected to a single insult of blast OP. Materials and Methods: Sagittal brainstem sections and horizontal cervical spinal cord sections from blast and sham animals were stained by neurofilament light (NF-L) chain and beta amyloid precursor protein immunocytochemistry and observed for axonal injury changes. Results: Observations from this preliminary study demonstrate axonal injury changes in the form of prominent swellings, retraction bulbs, and putative signs of membrane disruptions in the brainstem and cervical spinal cord WM tracts of rats subjected to blast OP. Conclusions: Prominent axonal injury changes following the blast OP exposure in brainstem and cervical spinal WM tracts underscores the need for careful evaluation of blast induced injury changes and associated symptoms. NF-L immunocytochemistry can be considered as an additional tool to assess the blast OP induced axonal injury.


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