François-Xavier Ferracci1, Donatien Heuze2, Riccardo Sacco2,3, Jonathan Curado2, Antoine Monnot2,3, Fabrice Duparc2, Mourad Ould-Slimane4,5. 1. Clairval private hospital, 317 Bvd du Redon, 13273, Marseille, France. 2. Department of Orthopaedic Surgery, Spine unit, Rouen University Hospital, 1, rue de Germont, 76031, Rouen Cedex, France. 3. Rouen University Hospital, Spine Institute, 76031, Rouen, France. 4. Department of Orthopaedic Surgery, Spine unit, Rouen University Hospital, 1, rue de Germont, 76031, Rouen Cedex, France. Mourad.ould-slimane@chu-rouen.fr. 5. Rouen University Hospital, Spine Institute, 76031, Rouen, France. Mourad.ould-slimane@chu-rouen.fr.
Abstract
PURPOSE: To describe the management of the discovery of a retropharyngeal carotid artery in the context of a cervical dislocation. DESCRIPTION OF THE CASE: A 68-year-old female presented acute neck pain and incomplete tetraplegia following a fall on the stairs. Radiographs, contrast-enhanced computed tomography scan and magnetic resonance of the cervical spine revealed a C5-C6 bi-articular dislocation. A detailed preoperative assessment of the images discovered a medialization of the left common carotid artery. An external reduction and a left anterior cervical approach allowed a careful management of the vascular variation and an anterior C5-C6 arthrodesis. At six months, a full neurological recovery was assessed and radiographs demonstrated successful fusion of the cervical arthrodesis. DISCUSSION/ CONCLUSION: Anatomical features such as medialization of the common carotid artery may affect patients with traumatic cervical spine injuries. The severity of the traumatic bone lesions should not overshadow the preoperative analysis of the adjacent anatomical structures encountered during the surgical approach, even in an emergency situation.
PURPOSE: To describe the management of the discovery of a retropharyngeal carotid artery in the context of a cervical dislocation. DESCRIPTION OF THE CASE: A 68-year-old female presented acute neck pain and incomplete tetraplegia following a fall on the stairs. Radiographs, contrast-enhanced computed tomography scan and magnetic resonance of the cervical spine revealed a C5-C6 bi-articular dislocation. A detailed preoperative assessment of the images discovered a medialization of the left common carotid artery. An external reduction and a left anterior cervical approach allowed a careful management of the vascular variation and an anterior C5-C6 arthrodesis. At six months, a full neurological recovery was assessed and radiographs demonstrated successful fusion of the cervical arthrodesis. DISCUSSION/ CONCLUSION: Anatomical features such as medialization of the common carotid artery may affect patients with traumatic cervical spine injuries. The severity of the traumatic bone lesions should not overshadow the preoperative analysis of the adjacent anatomical structures encountered during the surgical approach, even in an emergency situation.