C6-C7 subluxation and the importance of simple radiology in the emergency department. A case report and literature review

• Published in: Revista de neurologiá Vol. 29; no. 11; pp. 1035 - 1037
• Main Authors: Coloma-Valverde, G, Granado-Peña, J M, Estévez-Rosas, S
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.12.1999
• Subjects: Adult; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - pathology; Cervical Vertebrae - surgery; Diagnosis, Differential; Emergency Medical Services; Female; Humans; Magnetic Resonance Imaging; Radiography; Spinal Diseases - diagnostic imaging; Spinal Diseases - pathology; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - pathology; Spinal Neoplasms - surgery
• ISSN: 0210-0010

Post-traumatic fractures and luxations of the cervical spine are commonest in young patients. A good basic radiological study of the region between the occipitocervical joint and the first thoracic vertebra is essential. The antialgic spasm which causes the shoulders to be raised means that their image is superimposed on that of the cervico-dorsal vertebrae hiding the latter. Suitable technical measures should be taken for X-ray images of this area. If these are not satisfactory, computerized tomography (CT) or magnetic resonance (MR) are indicated. We present the case of a twenty year old woman who presented after cervical hyperextension due to a road traffic accident. She had been attended in the Emergency Department of another hospital, where she went complaining of bilateral cervicobrachial pain. Plain antero-posterior and lateral X-rays were done showing as far as C6. The patient was discharged on analgesics and muscle relaxants. Her symptoms did not improve so she was sent for rehabilitation. Even so, she became paraplegic three months later. On MR subluxation of C6-C7, an extradural intraspinal space-occupying lesion and osteolysis of C7 were seen. An emergency operation was done. The C7 vertebra was removed together with a very vascular mass. Histological study showed that it was a giant cell tumour. Subsequently, the patient recovered movement of her legs and radiotherapy was started.