Anouar Bourghli1, Clement Ribes2, Ibrahim Obeid2, Louis Boissiere2, Jean-Marc Vital2. 1. Orthopedic Spinal Surgery Unit, Bordeaux Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux Cedex, France. anouar.bourghli@gmail.com. 2. Orthopedic Spinal Surgery Unit, Bordeaux Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux Cedex, France.
Abstract
INTRODUCTION: We report the rare case of a 27-year-old man who presented a right sided complete hemiplegia after a neck trauma due to a road traffic accident. MATERIALS AND METHODS: Computed tomography revealed a complete fracture of the C6 lamina including a partial fracture of the right articular process with complete rotation of the fragment into the spinal canal with a major compression of the right side of the cord. The patient was operated urgently and underwent posterior approach for C6 arch removal followed by a C6C7 anterior fusion as T2 weighted magnetic resonance imaging revealed a completely torn C6C7 disc with a hematoma under the posterior longitudinal ligament associated with an increased cord signal. Patient could walk normally 6 weeks after the accident. At 2 years follow-up, he recovered full sensation of his right body but had a residual intrinsic muscle weakness in his right hand. CONCLUSION: This is the first paper, in the literature, to describe a complete laminar fracture at the cervical spine level with hemiplegia. Early surgical intervention probably provides the better neurological outcome.
INTRODUCTION: We report the rare case of a 27-year-old man who presented a right sided complete hemiplegia after a neck trauma due to a road traffic accident. MATERIALS AND METHODS: Computed tomography revealed a complete fracture of the C6 lamina including a partial fracture of the right articular process with complete rotation of the fragment into the spinal canal with a major compression of the right side of the cord. The patient was operated urgently and underwent posterior approach for C6 arch removal followed by a C6C7 anterior fusion as T2 weighted magnetic resonance imaging revealed a completely torn C6C7 disc with a hematoma under the posterior longitudinal ligament associated with an increased cord signal. Patient could walk normally 6 weeks after the accident. At 2 years follow-up, he recovered full sensation of his right body but had a residual intrinsic muscle weakness in his right hand. CONCLUSION: This is the first paper, in the literature, to describe a complete laminar fracture at the cervical spine level with hemiplegia. Early surgical intervention probably provides the better neurological outcome.
Authors: G D Carlson; Y Minato; A Okada; C D Gorden; K E Warden; J M Barbeau; C L Biro; E Bahnuik; H H Bohlman; J C Lamanna Journal: J Neurotrauma Date: 1997-12 Impact factor: 5.269