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Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury

INTRODUCTION: The sub axial cervical spine is a common site for traumatic spine injury, the injury of which can be life-threatening and can also result in permanent disability. Subaxial cervical spine injury has been classified by Allen and Ferguson (earliest classification), subaxial cervical spine...

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Autores principales: Kumar, Vishal, Dhatt, Sarvdeep Singh, Neradi, Deepak, Gaurav, Ankit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983406/
https://www.ncbi.nlm.nih.gov/pubmed/36873321
http://dx.doi.org/10.13107/jocr.2022.v12.i09.3004
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author Kumar, Vishal
Dhatt, Sarvdeep Singh
Neradi, Deepak
Gaurav, Ankit
author_facet Kumar, Vishal
Dhatt, Sarvdeep Singh
Neradi, Deepak
Gaurav, Ankit
author_sort Kumar, Vishal
collection PubMed
description INTRODUCTION: The sub axial cervical spine is a common site for traumatic spine injury, the injury of which can be life-threatening and can also result in permanent disability. Subaxial cervical spine injury has been classified by Allen and Ferguson (earliest classification), subaxial cervical spine injury classification system (SLICS) and AO spine classification. Allen and Ferguson system has significant inter-observer variations and is difficult to apply clinically at times. SLICS does not guide in the choice of surgical approach and score can vary between individuals because of different magnetic resonance imaging interpretations for discoligamentous injury. AO spine classification system has low agreement rate for intermediate morphology types (A1-4 and B) and not all injury patterns fit in the AO spine classification system like the case presented herein. In this case report, we address an unusual presentation of the flexion-compression mechanism of injury. This fracture morphology does not fit in any of the above mentioned classification system, so we are reporting this case and this is the first report of this kind in the literature. CASE REPORT: An 18-year-old male presented to our emergency department with a history of fall of heavy object on his head from above. On presentation, the patient was in shock and respiratory distress. The patient was intubated and resuscitated gradually. Non-contrast computed tomography of the cervical spine showed isolated retropulsion of the C5 body without any displacement of facet joints or pedicle fracture. This injury was also associated with a fracture of the posterosuperior portion of the C6 vertebral body. The outcome was the death of the patient 2 days after injury. CONCLUSION: The cervical spine is a common segment of the spine that is prone to injuries due to its anatomy and flexibility. The same injury mechanism can lead to varied and unique presentations. Each classification system for cervical spine injury has its drawback, cannot be universalized, and more research is needed to develop a classification system with an international agreement for diagnosing, classifying, and treating the injury for better patient outcomes.
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spelling pubmed-99834062023-03-04 Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury Kumar, Vishal Dhatt, Sarvdeep Singh Neradi, Deepak Gaurav, Ankit J Orthop Case Rep Case Report INTRODUCTION: The sub axial cervical spine is a common site for traumatic spine injury, the injury of which can be life-threatening and can also result in permanent disability. Subaxial cervical spine injury has been classified by Allen and Ferguson (earliest classification), subaxial cervical spine injury classification system (SLICS) and AO spine classification. Allen and Ferguson system has significant inter-observer variations and is difficult to apply clinically at times. SLICS does not guide in the choice of surgical approach and score can vary between individuals because of different magnetic resonance imaging interpretations for discoligamentous injury. AO spine classification system has low agreement rate for intermediate morphology types (A1-4 and B) and not all injury patterns fit in the AO spine classification system like the case presented herein. In this case report, we address an unusual presentation of the flexion-compression mechanism of injury. This fracture morphology does not fit in any of the above mentioned classification system, so we are reporting this case and this is the first report of this kind in the literature. CASE REPORT: An 18-year-old male presented to our emergency department with a history of fall of heavy object on his head from above. On presentation, the patient was in shock and respiratory distress. The patient was intubated and resuscitated gradually. Non-contrast computed tomography of the cervical spine showed isolated retropulsion of the C5 body without any displacement of facet joints or pedicle fracture. This injury was also associated with a fracture of the posterosuperior portion of the C6 vertebral body. The outcome was the death of the patient 2 days after injury. CONCLUSION: The cervical spine is a common segment of the spine that is prone to injuries due to its anatomy and flexibility. The same injury mechanism can lead to varied and unique presentations. Each classification system for cervical spine injury has its drawback, cannot be universalized, and more research is needed to develop a classification system with an international agreement for diagnosing, classifying, and treating the injury for better patient outcomes. Indian Orthopaedic Research Group 2022-09 2022-09 /pmc/articles/PMC9983406/ /pubmed/36873321 http://dx.doi.org/10.13107/jocr.2022.v12.i09.3004 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kumar, Vishal
Dhatt, Sarvdeep Singh
Neradi, Deepak
Gaurav, Ankit
Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title_full Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title_fullStr Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title_full_unstemmed Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title_short Isolated Retropulsion of C5 Cervical Vertebral Body without any Displacement of Facet Joints: A Case Report on an Unusual Presentation of Cervical Spine Injury
title_sort isolated retropulsion of c5 cervical vertebral body without any displacement of facet joints: a case report on an unusual presentation of cervical spine injury
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983406/
https://www.ncbi.nlm.nih.gov/pubmed/36873321
http://dx.doi.org/10.13107/jocr.2022.v12.i09.3004
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