Multiple Noncontiguous Fractures in Cervical Spine - Cases Report -

Myoung Soo Kim; Chang Bum Lee; Jeong Han Ha; Hyung Taek Park; Sun Jin Choi; Jong Hoon Park

doi:10.4184/JKSS.2010.17.1.26

Journal List > J Korean Soc Spine Surg > v.17(1) > 1075916

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Lee, Ha, Park, Choi, and Park: Multiple Noncontiguous Fractures in Cervical Spine - Cases Report -

Case Report

J Korean Soc Spine Surg 2010;17(1):26-32.

Published online: 18 March 2010

DOI: https://doi.org/10.4184/JKSS.2010.17.1.26

Multiple Noncontiguous Fractures in Cervical Spine - Cases Report -

Myoung Soo Kim, M.D., Chang Bum Lee, M.D.^∗,, Jeong Han Ha, M.D.^∗, Hyung Taek Park, M.D.^∗, Sun Jin Choi, M.D.^∗, Jong Hoon Park, M.D.^∗

Department of Orthopaedic Surgery, Pusan National University School of Medicine, Busan, Korae

^∗Department of Orthopaedic Surgery, Maryknoll Hospital, Busan, Korea

Corresponding auther: Chang Bum Lee, M.D. Department of Orthopaedic Surgery, Maryknoll Hospital 4-12 Daecheongdong, Jung-gu, Busan, Korea TEL: 82-51-465-8801, FAX : 82-51-463-1194 E-mail: nexgens@hanmail.net

Received 23 June 2009 Accepted 17 November 2009

“This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.”

Abstract

Study Design

Cases report

Objectives

We report 2 cases of relatively rare cervical fracture.

Summary of Literature Review

Although numerous studies in the literature have investigated cervical spine injuries, patients with multiple-level cervical fractures have not been commonly described. Multiple non-contiguous cervical fractures are distinctively unusual.

Materials and Methods

First case was a girl aged 8 years and 4 months who had multifocal compression fracture of C3, 5, 6 & T7, 8 without spinal cord injury. Second case was a thirty nine-year-old female who had Type I Hangman's fracture and compression fractures of C3, 7.

Results

We had satisfactory results of them treated nonsurgically.

Conclusions

We should remind that cervical spinal column can incur multiple injuries in variant patterns.

Keywords: Cervical spine, Multiple noncontiguous fractures

REFERENCES

1.Calenoff L., Chessare JW., Rodgers LF., Toerge J., Rosen JS. Multiple level spinal injuries: importance of early recognition. AJR. 1978. 130:665–9.

2.Kewalramani LS., Taylor RG. Multiple noncontiguous injuries to the spine. Acta Ortho Scand. 1976. 47:52–8.

3.Gupta A., El Masri WS. Multilevel spinal injuries. Incidence, distribution and neurological patterns. J Bone Joint Surg Br. 1989. 71:692–5.

4.Vaccaro AR., An HS., Lin S., Sun S., Balderston RA., Cotler JM. Noncontiguous injuries of the spine. Journal of Spinal Disorders. 1992. 5:320–9.

5.Shear P., Hugenholtz H., Richard MT, et al. Multiple noncontiguous fractures of the cervical spines. J Trauma. 1988. 28:655–59.

6.Levine AM., Edwards CC. The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am. 1985. 67:217–26.

7.Birney TJ., Hanley EN Jr. Traumatic cervical injuries in childhood and adolescence. Spine. 1989. 14:1277–82.

8.Ruge JR., Sinson GP., McLone DG., Cerullo LJ. Pediatric spinal injury: the very young. J Neurosurg. 1988. 68:25–30.

9.Letts M., Davidson D., Healey D. Simultaneous fracture of every cervical vertebra: a case study. Spine. 2002. 27:446–50.

10.Tannoury TY., Zmurko MG., Tannoury CA., Anderson DG., Chan DP. Multiple unstable cervical fractures with cord compromise treated nonoperatively: a case report. Spine. 2004. 29:234–8.

Fig. 1.

Plain radiograph and CT scan show wedging compression of C6 without retro-pulsion of bony fragment and mild kyphotic angulation of cervical curve. Spinal canal is relatively preserved.

Fig. 2.

MRI scan shows marked compression and anterior wedging of C6 spine with minimal spinal canal narrowing. Multifocal high signal intensity on T2WI and STIP image with contrast enhancement are seen in other spines (C3, C5, T7 and T8) suggesting multifocal acute compression fracture. Significant abnormal spinal cord signal is not seen.

Fig. 3.

9 months after injury: Mild kyphotic angulation of cervical curve is remained.

Fig. 4.

Plain radiograph and CT scan show bilateral symmetrical fractures detaching the pedicles from the body of C2 (Hangman's fracture) and linear fracture lines in the anterior body of the C7

Fig. 5.

MRI scan shows the loss of height of the C3 and C7 body, with hyposignal on T1WI, and hypersignal on T2WI. The compressive myelopathy is not seen in the cervical spinal cord.

Fig. 6.

After halovest immobilization, plain radiograph shows well reduction state of C2 and lordotic curve.

Fig. 7.

12 weeks after injury: Dynamic view of cervical column showed acceptable stabilization and union of Hangman's fracture.

TOOLS

Similar articles