Fracture-dislocation of the cervical spine with ankylosing spondylitis

1973 ◽  
Vol 39 (6) ◽  
pp. 764-769 ◽  
Author(s):  
Carroll Osgood ◽  
Louis G. Martin ◽  
Elliott Ackerman
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Predisposing Factors ◽  
Neurological Deficits ◽  
Fracture Dislocation ◽  
Cervical Fracture ◽  
Review Of The Literature ◽  
Content Type ◽  
Fine Print

✓ Two cases of cervical fracture-dislocation causing neurological deficits in patients with ankylosing spondylitis are presented. Review of the literature shows that these patients have a higher incidence of neurological deficits (70%) than comparable patients without ankylosing spondylitis (44%). Predisposing factors and treatment are discussed.

Discography and myelography in acute injuries of the cervical spine

1971 ◽  
Vol 35 (5) ◽  
pp. 529-535 ◽  
Author(s):  
Richard B. Raynor
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Fracture Dislocation ◽  
Cervical Fracture ◽  
Content Type ◽  
Relative Safety ◽  
Acute Injuries ◽  
Fine Print

✓ Nineteen patients who suffered trauma to the cervical spine that resulted in moderate to severe neurological deficit were studied by discography. In 15 cases, myelography was also performed. When both tests were done there was good correlation of results. In the four cases where only discography was performed, the lesion was accurately localized. The danger of myelography in acute cervical fracture dislocation is emphasized and the relative safety, ease, and value of discography stressed.

Complete fracture-dislocation of cervical spine without permanent neurological sequelae

1983 ◽  
Vol 58 (5) ◽  
pp. 760-762 ◽  
Author(s):  
Roy P. Baker ◽  
Robert L. Grubb
Keyword(s):  
Cervical Spine ◽  
Neurological Deficits ◽  
Fracture Dislocation ◽  
Multiple Fractures ◽  
Neurological Sequelae ◽  
Content Type ◽  
Primary Mechanism ◽  
Complete Fracture ◽  
Type Of Injury ◽  
Fine Print

✓ A case of complete fracture-dislocation of the lower cervical spine in which there were no permanent neurological sequelae is presented. The absence of permanent neurological deficits with this type of injury is rare. The primary mechanism of injury in this patient was believed to be hyperextension with rupture of the ligamentous structures, allowing complete dislocation of the C-6 body while the posterior elements remained in good alignment due to multiple fractures which “decompressed” the spinal cord.

Progressive neurological deficits with benign intracerebral cysts

1986 ◽  
Vol 65 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Yoko Nakasu ◽  
Jyoji Handa ◽  
Kazuyoshi Watanabe
Keyword(s):  
Histological Examination ◽  
Computerized Tomography ◽  
Cyst Wall ◽  
Benign Lesion ◽  
Ct Scanning ◽  
Neurological Deficits ◽  
Review Of The Literature ◽  
Content Type ◽  
Ct Findings ◽  
Fine Print

✓ Two patients with benign intracerebral cysts are reported and a brief review of the literature is given. Although computerized tomography (CT) scanning is useful in detecting a variety of intracerebral cysts, the CT findings are not specific for any lesion. An exploratory operation with establishment of an adequate route of drainage and a histological examination of the cyst wall are mandatory in the management of patients with a progressive but benign lesion.

Fracture dislocation of the cervical spine with gross displacement

1975 ◽  
Vol 42 (2) ◽  
pp. 209-211 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Content Type ◽  
Fine Print

✓ A case of cervical spine injury is presented in which complete displacement of one vertebral body was accompanied by only mild quadriparesis.

Risk of early closed reduction in cervical spine subluxation injuries

1999 ◽  
Vol 90 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Gerald A. Grant ◽  
Sohail K. Mirza ◽  
Jens R. Chapman ◽  
H. Richard Winn ◽  
David W. Newell ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Mr Imaging ◽  
Disc Herniation ◽  
Closed Reduction ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Neurological Deterioration ◽  
Neurological Deficits ◽  
Content Type ◽  
Fine Print

Object. The authors retrospectively reviewed 121 patients with traumatic cervical spine injuries to determine the risk of neurological deterioration following early closed reduction. Methods. After excluding minor fractures and injuries without subluxation, the medical records and imaging studies (computerized tomography and magnetic resonance [MR] images) of 82 patients with bilateral and unilateral locked facet dislocations, burst fractures, extension injuries, or miscellaneous cervical fractures with subluxation were reviewed. Disc injury was defined on MR imaging as the presence of herniation or disruption: a herniation was described as deforming the thecal sac or nerve roots, and a disruption was defined as a disc with high T2-weighted signal characteristics in a widened disc space. Fifty-eight percent of patients presented with complete or incomplete spinal cord injuries. Thirteen percent of patients presented with a cervical radiculopathy, 22% were intact, and 9% had only transient neurological deficits in the field. Early, rapid closed reduction, using serial plain radiographs or fluoroscopy and Gardner—Wells craniocervical traction, was achieved in 97.6% of patients. In two patients (2.4%) closed reduction failed and they underwent emergency open surgical reduction. The average time to achieve closed reduction was 2.1 ± 0.24 hours (standard error of the mean). The incidence of disc herniation and disruption in the 80 patients who underwent postreduction MR imaging was 22% and 24%, respectively. However, the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association motor score and the Frankel scale following early closed reduction. Only one (1.3%) of 80 patients deteriorated, but that occurred more than 6 hours following closed reduction. Conclusions. Although disc herniation and disruption can occur following all types of traumatic cervical fracture subluxations, the incidence of neurological deterioration following closed reduction in these patients is rare. The authors recommend early closed reduction in patients presenting with significant motor deficits without prior MR imaging.

scholarly journals Catastrophic neurological complications of emergent endotracheal intubation: report of 2 cases

2015 ◽  
Vol 22 (5) ◽  
pp. 454-458 ◽  
Author(s):  
Mark E. Oppenlander ◽  
Forrest D. Hsu ◽  
Patrick Bolton ◽  
Nicholas Theodore
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Endotracheal Intubation ◽  
Open Reduction ◽  
Neurological Complications ◽  
Fracture Dislocation ◽  
Posterior Fixation ◽  
Cervical Fracture ◽  
First Report ◽  
Spine Pathology

Although exceedingly rare, catastrophic neurological decline may result from endotracheal intubation of patients with preexisting cervical spine disease. The authors report on 2 cases of quadriplegia resulting from emergent endotracheal intubation in the intensive care unit. A 68-year-old man with ankylosing spondylitis became quadriplegic after emergent intubation. A new C6–7 fracturedislocation was identified, and the patient underwent emergent open reduction and C4–T2 posterior fixation and fusion. The patient remained quadriplegic and ultimately died of pneumonia 1 year later. This is the first report with radiographic documentation of a cervical fracture-dislocation resulting from intubation in a patient with ankylosing spondylitis. A 73-year-old man underwent posterior C6–T1 decompression and fixation for a C6–7 fracture. On postoperative Day 12, emergent intubation for respiratory distress resulted in C6-level quadriplegia. Imaging revealed acute spondyloptosis at C6–7, and the patient underwent emergent open reduction with revision and extension of posterior fusion from C-3 to T-2. He remained quadriplegic and ventilator dependent. Five days after the second operation, care was withdrawn. This is the first report of intubation as a cause of significant neurological decline related to disruption of a recently fixated cervical fracture. Risk factors are identified and pertinent literature is reviewed for cases of catastrophic neurological complications after emergent endotracheal intubation. Strategies for obtaining airway control in patients with cervical spine pathology are also identified. Awareness of the potential dangers of airway management in patients with cervical spine pathology is critical for all involved subspecialty team members.

Delayed paralysis after cervical fracture-dislocation

1977 ◽  
Vol 46 (4) ◽  
pp. 512-516 ◽  
Author(s):  
James C. White ◽  
Lawrence W. Kneisley ◽  
Alain B. Rossier
Keyword(s):  
Spinal Cord ◽  
Nerve Injury ◽  
Fracture Dislocation ◽  
Sensory Loss ◽  
Late Development ◽  
Cervical Fracture ◽  
Content Type ◽  
Upper Cervical ◽  
Fine Print

✓ The authors describe the late development of ascending damage to the spinal cord after a cervicothoracic fracture-dislocation that produced no evidence of cord or nerve injury other than transient mild paresthesia in the arms. After 16 years, progressive quadriplegia developed with subsequent ascending dissociated sensory loss in the upper cervical dermatomes. The presence of a central syrinx was verified at operation 18 years after the injury.

Neurological complications of ankylosing spondylitis

1993 ◽  
Vol 78 (6) ◽  
pp. 871-878 ◽  
Author(s):  
Mark W. Fox ◽  
Burton M. Onofrio ◽  
John E. Kilgore
Keyword(s):  
Ankylosing Spondylitis ◽  
Spinal Column ◽  
Spinal Fractures ◽  
Neurological Complications ◽  
Neurological Deficits ◽  
Successful Outcome ◽  
Spinal Instability ◽  
Spinal Disorders ◽  
Content Type ◽  
Fine Print

✓ Thirty-three patients with ankylosing spondylitis with or without spinal neurological symptoms requiring surgical intervention were identified in a retrospective review of all cases of spinal disorders treated at the Mayo Clinic during the period from 1984 to 1989. Spinal fractures (traumatic or pseudoarthroses), progressive spinal deformity, rotary instability secondary to atlanto-occipital or atlantoaxial subluxation, and spinal stenosis with associated neurological deficit, pain, or spinal instability were the most common indications for surgery. Of the 41 operations performed, there were 17 cervical, 14 thoracic, and 10 lumbar procedures. Eight patients had two or more disorders at separate spinal levels that required surgery. Preoperative neurological deficits were recorded in 13 patients: these improved following surgery in nine and stabilized in four. This review emphasizes the fragility of the ankylosed spinal column and its inherent susceptibility to fracture with attendant neurological compromise. It also identifies the variety of spinal disorders observed in these patients and discusses their surgical management. The experience with this series suggests that thorough radiological evaluation, extreme caution with endotracheal intubation and with halo-vest applications, early surgical spinal immobilization, and aggressive postoperative mobilization of patients are necessary for a successful outcome. It is concluded that outcomes in these patients can be favorable when managed appropriately.

Chondrosarcoma of the cervical spine

1976 ◽  
Vol 44 (4) ◽  
pp. 500-503 ◽  
Author(s):  
Russell L. Blaylock ◽  
Ludwig G. Kempe
Keyword(s):  
Cervical Spine ◽  
Lateral Mass ◽  
Review Of The Literature ◽  
Total Removal ◽  
Content Type ◽  
Radical Removal ◽  
Fine Print

✓ The authors present a case of chondrosarcoma involving the lateral mass of the C-2 vertebra, treated by an apparent total removal of the tumor. A review of the literature revealed that these patients can be cured in a significant number of cases if a radical removal is accomplished.

A portable traction device for cervical fractures

1992 ◽  
Vol 76 (3) ◽  
pp. 544-545 ◽  
Author(s):  
Ray H. Kinnaird ◽  
Richard K. Jelsma
Keyword(s):  
Cervical Spine ◽  
Radiographic Evaluation ◽  
Cervical Fracture ◽  
Content Type ◽  
Cervical Fractures ◽  
Traction Device ◽  
Fine Print

✓ A lightweight and completely self-contained traction device is described. It has been used to immobilize the cervical spine during radiographic evaluation and treatment of patients with cervical fracture, and for therapeutic traction in patients with a ruptured disc. Other applications are possible, but have not yet been investigated

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