Lower Cervical Spine Fractures and Dislocations

14 year old male gymnast (Hong Kong Junior Team)

Fall during practice on Mid June 2006

Landed on left side of head neck and shoulder

Main complaint neck pain and left hand numbness over left radial 3 digits

Hospitalized in China

DIAGNOSIS:

Left C6/7 unilateral facet fracture dislocation

C6/7 disc prolapse with inferior endplate fracture of C6 vertebra

Left C7 radiculopathy from compressed nerve root in neural foramen

Cervical central canal stenosis but cervical spinal cord not compressed

OPTIONS:

Reduction

Need for decompression?

Fixation

PROCEDURE:

Combined Posterior Anterior Approach

Posterior reduction decompression left C6/7 facet fracture dislocation

Left Oblique facet wiring

Interspinous process wiring

ACDF C6/7

CEPHALIC

CAUDAL

LEFT

RIGHT

PROGRESS:

Solid fusion @ 6 months

Back to competitive gymnastic training in Jan 2007

No numbness or weakness detected

Example 2

UNILATERAL FACET FRACTURE DISLOCATION

SPINE CARE HONG KONG

ACCURATE DIAGNOSIS, STRUCTURED TREATMENT