++
Case 16-1: Recovery from a severe cervical spine injury
++
A 19-year-old dove into a shallow lake.
++
++
++
The patient was in mild painful distress. He was awake, alert and oriented with significant motor and sensory deficits. The patient had no sensation below the C4 level. He had no rectal tone and had priapism. His only motor function was an inconsistent flicker of movement in one of his feet.
++
++
An initial lateral cervical spine radiograph demonstrated a fracture/dislocation at the C3-C4 level. Marked narrowing of the width of his spinal canal was evident. The patient was lightly sedated, Gardner-Wells cervical tongs were placed, and a series of increasing weights were applied as traction. Within 90 minutes from injury, reduction of the fracture/dislocation was obtained with a markedly increased spinal canal diameter.
++
Shortly after reduction, the patient began to regain sensory and motor function in a symmetrical pattern, starting with his lower extremities. He had a complete recovery of neurologic function.
++
-
The published case report for this patient gives additional details (see the first reference under Further Reading).
-
Early decompression of the cervical spinal cord appears to improve neurologic outcome.
+
Battistuzzo
CR, Armstrong
A, Clark
J,
et al. Early decompression following cervical spinal cord injury: examining the process of care from accident scene to surgery.
J Neurotrauma. 2016;33(12):1161–1169.
[PubMed: 26650510]
+
Brunette
DD, Rockswold
GL. Neurologic recovery following rapid spinal realignment for complete cervical spinal cord injury.
J Trauma. 1987;27(4):445–447.
[PubMed: 3573096]
+
Evaniew
N, Noonan
VK, Fallah
N,
et al. Methylprednisolone for the treatment of patients with acute spinal cord injuries: a propensity score-matched cohort study from a canadian multi-center spinal cord injury registry.
J Neurotrauma. 2015;32(21):1674–1683.
[PubMed: 26065706]
+
Li
Y, Walker
CL, Zhang
YP, Shields
CB, Xu
XM. Surgical decompression in acute spinal ...