Three Column Cervical Fracture-Dislocation in a 3-Year-Old Boy

Autor: Sivakanthan, Sananthan, Feroze, Abdullah, Eaton, Jessica, Saigal, Rajiv
Rok vydání: 2022
Předmět:
Zdroj: Cureus, vol 14, iss 3
ISSN: 2168-8184
DOI: 10.7759/cureus.23213
Popis: Complete traumatic cervical fracture-dislocation with spinal cord transection in children is a rare entity with no evidence-based guidelines on management. The authors reviewed the literature for pediatric spinal cord injury and present the case of a 3-year-old with traumatic cervical fracture-dislocation and spinal cord transection who presented as a cervical-6complete spinal cord injury (ASIA A). His other organ systems injured includedliver, spleen,bowel, andabdominal aortic injury. The patient underwent halo placement for preoperative reduction followed by open reduction and internal fixation with posterior segmental instrumented fusion. Intraoperatively, the patient had motor evoked potential signals present below the level of his injury. Early postoperative follow-up demonstrated that, although his leg function did not improve, he did demonstrate improvement in upper extremities. This is a rare case of complete cervical spinal cord transection in a pediatric patient. We elected to manage this challenging case with initial external reduction and orthosis with a halo vest followed by acute posterior cervical fusion. Despite a cervical-6 injury level on clinical exam, there was electrographic evidence of function below that level on intraoperative neuromonitoring. Postoperatively the patient has recovered some lost function.
Databáze: OpenAIRE
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