Multilevel contiguous injuries of the lower cervical spine during flexion trauma with delayed diagnosis: a case report

• Published in: Neuro-chirurgie Vol. 55; no. 6; pp. 585 - 588
• Main Authors: Uzel, A-P, Do, L
• Format: Journal Article
• Language: French; English
• Published: France 01.12.2009
• Subjects: Accidents, Traffic; Adolescent; Arthrodesis; Bone Plates; Cervical Vertebrae - pathology; Fluoroscopy; Fracture Fixation; Humans; Joint Dislocations - diagnosis; Joint Dislocations - pathology; Magnetic Resonance Imaging; Male; Multiple Trauma - diagnosis; Multiple Trauma - pathology; Spinal Injuries - diagnosis; Spinal Injuries - pathology; Sprains and Strains - diagnosis; Sprains and Strains - pathology; Tomography, X-Ray Computed
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2009.04.002

The authors report a case of bilateral C4-C5 facet fracture dislocation associated with a severe sprain underlying C5-C6, which had occurred during an traffic accident. The diagnosis of severe sprain was raised on the 55 th day. The injury mechanism is studied. Contiguous multilevel injuries of the lower cervical spine should be suspected in case of high-energy trauma. MRI can provide an exhaust if diagnosis of possible multilevel injuries. After fixation of the obvious lesion, intraoperative dynamic fluoroscopy must be performed to demonstrate any instability in another area.