C2-C3 Spinal Fracture Subluxation with Ligamentous and Vascular Injury: a Case Report and Review of Management

Overview

Journal Spinal Cord Ser Cases

Specialty Neurology

Date 2019 Jan 25

PMID 30675388

Citations 1

Authors

Hepzibha Alexander

Ehsan Dowlati

Jason E McGowan

Robert B Mason

Amjad Anaizi

Affiliations

Soon will be listed here.

Abstract

Introduction: Spinal cord injury is one of the leading causes of paralysis and permanent morbidity. High cervical spine injuries, in particular, have the potential to be fatal and debilitating due to injury to multiple components, including but not limited to, discoligamentous disruption, vascular insult and spinal cord injury. To date, no unifying algorithm exists making it challenging to guide treatment decisions.

Case Presentation: We present the case of a 29-year-old polytrauma patient with an unstable C2-C3 fracture subluxation secondary to hyperextension and rotation injury with complete ligamentous dissociation and vertebral artery dissection after a high-velocity injury. We review the literature on injury patterns, associated complications and neurological outcomes in subaxial cervical spine injuries.

Discussion: Our patient's injuries had several components including fracture subluxation, ligamentous disruption, central cord syndrome, and vascular insult. The lack of a unifying algorithm to guide treatment decisions highlights the variations in pathology and subsequent limitations in generalizability of current literature. Our patient underwent an open anterior C2-C3 reduction and discectomy with fusion and plating and a subsequent C2-C4 posterior instrumented fusion. The patient regained some motor function postoperatively and through rehabilitation. Careful consideration of multiple components is crucial when treating subaxial spine injuries.

Citing Articles

C2-3 Fracture Dislocation and Bilateral Vertebral Artery Occlusion Without Neurological Injury: A Case Report.

Kiessling J, Whitney E, Fiani B, Khan Y, Mahato D Cureus. 2019; 11(8):e5538.

PMID: 31687311 PMC: 6819066. DOI: 10.7759/cureus.5538.

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