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Lower Cervical Spine Fractures and Dislocations |
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Copyright © 2008 Spine Care Hong Kong |
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EXAMPLE 2 UNILATERAL CERVICAL FACET FRACTURE DISLOCATION |
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DIAGNOSIS: Left C6/7 unilateral facet fracture dislocation with fracture of left C7 lateral mass Preexisting cervical spondylosis Already dessicated C6/7 intervertebral disc No significant disc fragment or prolapse Left C7 radiculopathy from compressed nerve root in neural foramen Cervical central canal mild stenosis but cervical spinal cord not compressed
OPTIONS: Reduction method Need for decompression? Fixation method
PROCEDURE: Posterior Approach for decompression, instrumentation and fusion Open Reduction Cervical Pedicle Screw C6 C7 CPS has 3x pull out strength of lateral mass screw Achieve 3 column (ie anterior stability) Foraminotomy left C6-7 Excision fracture of lateral mass C7 |
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PROGRESS: Rotatory neck deformity corrected Numbness and arm pain resolved |
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Female mid forties Skiing injury early February 2008 Main complaint of severe left sided neck pain and stiffness, right ankle fracture
Examination left index and middle finger numbness weak left triceps right ankle fracture Transferred to Hong Kong 3 weeks after injury |
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C6-7 Fracture Dislocation |
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MRI - Cord Not Compressed |
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3D CT Reconstruction |
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SPINE CARE HONG KONG |
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ACCURATE DIAGNOSIS, STRUCTURED TREATMENT |
