scholarly journals Minimally displaced unilateral facet fracture of cervical spine can lead to spinal cord injury: a report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Satoshi Maki ◽  
Mitsuhiro Kitamura ◽  
Takeo Furuya ◽  
Takuya Miyamoto ◽  
Sho Okimatsu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Artery ◽  
Operative Treatment ◽  
Operative Management ◽  
Artery Injury ◽  
Cord Injury ◽  
Disc Injury ◽  
Facet Fracture ◽  
Non Operative Management

Abstract Background According to most of the commonly used classification systems for subaxial spine injuries, unilateral and minimally displaced facet fractures without any sign of a spinal cord injury would be directed to non-operative management. However, the failure rate of non-operative treatment varies from 20 to 80%, and no consensus exists with regard to predictors of failure after non-operative management. Case presentation Case 1 is a patient with a unilateral facet fracture. The patient had only numbness in the right C6 dermatome but failed non-operative treatment, which resulted in severe spinal cord injury. Case 2 is a patient who had a similar injury pattern as case 1 but presented with immediate instability and underwent fusion surgery. Both patients had a minimally displaced unilateral facet fracture accompanied by disc injury and blunt vertebral artery injury, which are possible signs indicating significant instability. Conclusions This is the first report of an isolated unilateral facet fracture that resulted in catastrophic spinal cord injury. These two cases illustrate that an isolated minimally displaced unilateral facet fracture with disc injury and vertebral artery injury were associated with significant instability that can lead to spinal cord injury.

Non-operative management of the urinary tract in spinal cord injury

1995 ◽  
Vol 14 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Roger R. Dmochowski ◽  
Kumaresan Ganabathi ◽  
Gary E. Leach
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract ◽  
Operative Management ◽  
Cord Injury ◽  
Non Operative Management

Navigation-Guided Subaxial Cervical Pedicle Screws in Revision Spine Surgery: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Jennifer Z Mao ◽  
Justice O Agyei ◽  
Moleca M Ghannam ◽  
Asham Khan ◽  
Marc Christensen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Artery ◽  
Pedicle Screws ◽  
Vertebral Artery Injury ◽  
Lateral Mass ◽  
Artery Injury ◽  
Cord Injury ◽  
Cervical Pedicle ◽  
Cervical Pedicle Screws

Abstract Traditionally, lateral mass screws (LMSs) have been the mainstay of posterior fixation in the subaxial spine. Although LMSs provide adequate fixation, cervical pedicle screws (CPSs) facilitate high fusion rates (90.5%) and provide for greater bone purchase, better reduction, lower rates of screw loosening or pull out, 2 times greater biomechanical advantage, superior stabilization, decreased development of pseudarthrosis, and decreased revision surgeries compared to LMSs.1-4 In addition, CPSs can be a powerful bail-out option after lateral mass construct failure. Navigation-guided CPS placement has been reported to have an accuracy of 90.3%.5 Navigation has the added advantage of mitigating screw malposition for the placement of CPS because of the smaller pedicle sizes and variability in cervical anatomy.1,3,6 The potential risks of subaxial CPS placement include the risks of vertebral artery injury, spinal cord injury, and injury to adjacent neurovasculature.2 The overall radiographic breach rate with intraoperative imaging is reported to range from 2.9% of 22.9%, with the majority of breaches occurring in the lateral direction.7,8 Despite radiographic breaches, the occurrence of nerve root injury (0.31% per screw), vertebral artery injury (0.15% per screw), and spinal cord injury (0% per screw) is rare.3,7 Here, we demonstrate navigation-assisted C1-C2 posterior fusion, with combined C1 LMSs and C2 pedicle screws with subaxial pedicle screw revision of prior failed instrumentation.3  The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary.

scholarly journals Sequential neurological improvements after conservative treatment in patients with complete motor paralysis caused by cervical spinal cord injury without bone and disc injury

2018 ◽  
Vol 29 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Eiji Mori ◽  
Takayoshi Ueta ◽  
Takeshi Maeda ◽  
Ryousuke Ideta ◽  
Itaru Yugué ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Conservative Treatment ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Neurological Improvement ◽  
Motor Paralysis ◽  
Cord Injury ◽  
Disc Injury

OBJECTIVEThis study investigated neurological improvements after conservative treatment in patients with complete motor paralysis caused by acute cervical spinal cord injury (SCI) without bone and disc injury.METHODSThis study was retrospective. The authors evaluated neurological outcomes after conservative treatment of 62 patients with complete motor paralysis caused by cervical SCI without bone and disc injury within 72 hours after trauma. The sequential changes in their American Spinal Injury Association Impairment Scale (AIS) grades were reviewed at follow-up 24–72 hours, 1 week, and 1, 3, and 6 months after treatment.RESULTSOf the 31 patients with a baseline AIS grade of A, 2 (6.5%) patients improved to grade B, 5 (16.1%) improved to grade C, and 2 (6.5%) improved to grade D by the 6-month follow-up. The 22 (71.0%) patients who remained at AIS grade A 1 month after injury showed no neurological improvement at the 6-month follow-up. Of the 31 patients with a baseline AIS grade of B, 12 (38.7%) patients showed at least a 1-grade improvement at the 1-month follow-up; 11 (35.5%) patients improved to grade C and 16 (51.6%) patients improved to grade D at the 6-month follow-up.CONCLUSIONSEven in patients with complete motor paralysis caused by cervical SCI without bone and disc injury within 72 hours after trauma, approximately 30% of the patients with an AIS grade of A and 85% of the patients with an AIS grade B improved neurologically after conservative treatment. It is very important to recognize the extent of neurological improvement possible with conservative treatment, even for severe complete motor paralysis.

scholarly journals Use of Fidji Cervical Cage in the Treatment of Cervical Spinal Cord Injury without Radiographic Abnormality

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Sheng-Li Huang ◽  
Hong-Wei Yan ◽  
Kun-Zheng Wang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Symptoms ◽  
Cervical Spinal Cord ◽  
Rare Condition ◽  
X Rays ◽  
Neurological Outcomes ◽  
Radiographic Abnormality ◽  
Cord Injury ◽  
Disc Injury

Spinal cord injury without radiographic abnormality (SCIWORA) is a rare condition seen in adults. Many interbody fusion cages have been developed for its treatment, but clinical studies of Fidji cervical cage are still scarce. A total number of five patients (four male and one female) were reviewed. The ages of the patients ranged from 40 to 60 years. All the patients underwent neurological and radiological examinations. Neurological and functional outcomes were assessed on the basis of Frankel’s grade. Three of the patients were Frankel B, and the rest two were Frankel C. Magnetic resonance imaging was also performed for the evaluation of spinal cord and intervertebral disc injury. Anterior cervical discectomy and Fidji cervical cage fusion were performed for all. The fusion status was evaluated on the basis of X-rays. After surgical intervention, the clinical symptoms improved for all the patients. The disc interspaces in all the patients achieved solid union at final follow-up. Fidji cervical cage is very efficient in achieving cervical fusion in patients with SCIWORA. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory.

Sign in / Sign up

Export Citation Format

Share Document