Rare case of survival after traumatic disruption of the cervical spine with combined complete spinal cord injury and bilateral vertebral arterial breakdown in an 18 month old patient
Complete cervical disruption is a rare and lethal injury secondary to high energy trauma. Bilateral vertebral arterial breakdown is also a rare and lethal injury. This is the first reported clinical case of an 18 month old girl who survived after combined cervical spinal cord disruption and bilateral vertebral arterial breakdown. Although she developed cardiopulmonary arrest at the accident site, resuscitation by a bystander, early fluid resuscitation, appropriate respiratory management, and subsequent surgical stabilization resulted in survival and preservation of higher cortical functions. She underwent surgery 1 week after hospitalization; her cervical spine was stabilized by posterior fixation using pedicle screws and transarticular screws. After the operation, the burst vertebra was gradually remodeled. Approximately 4 months later, she was transferred to a rehabilitation facility. Ten years later, she is attending to an elementary school, and she is able to speak and operate a wheelchair using a portable respiratory organ. We herein report an exceedingly rare case of cervical cord injury involving a combination of disruption of the cervical spine and bilateral vertebral arterial breakdown in a young child.
European Journal of Orthopaedic Surgery Traumatology