Methods (Diagnosis, investigations and treatment)
Diagnosis and Investigations: Computed tomography of the neck
objectified a posterior C5–C6 spondyloptosis allowed by a bipedicular
fracture of C6 [Figure 1A‑B]. An anterior spondylolisthesis of
C7-T1with bipedicular fracture of C7 were also found. No facet joint
dislocation was present. Two fragments were detached from C6 and C7 body
and reduced the spinal canal. There was a C5 anterior body fracture.
Magnetic resonance imaging was not available.
Treatment: Surgical intervention was done by anterior approach
only seven days after the trauma without preoperative cervical traction.
The patient underwent a two level cervical corpectomy (C6-C7) with iliac
crest fusion and rigid plate fixation. Patient was placed at supine
position under general anesthesia. Oblique incision along the medial
border of the right sternocleidomastoid muscle was given. After reaching
to the injured area, the traumatized vertebral bodies of C6 and C7 were
removed using Kerrison rongeur and bone-gouge forceps. The injured
posterior longitudinal ligament was also removed and complete
decompression of the cord was achieved. Tricortical iliac crest bone
graft was placed in the corpectomy defect after applying manual
traction. A rigid plate was fixed from C4 to T1 with two screws on C4,
one screw on the bone graft and two screws on T1 [Figure 2A‑B].
Corporeal fracture of C5 didn’t allow to put screws there.