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.