Summary
Burst fractures of the lower cervical spine (C3–7) are often associated with severe neurological injury. During the last 5 years (1987–1992) we operated on 11 patients who had sustained burst fractures together with neurological deficit. The operations were performed through an anterior approach. The burst vertebra was excised, and the defect was filled with bone graft. Implants (plates and screws) were used in 10 cases. The preoperative examination was conducted by computed tomography and revealed that in 4 patients with complete tetraplegia (Frankel grade A) there was more than 50% spinal canal narrowing, whilst in the remaining 7 patients, with various levels of incomplete tetraplegia, there was less than 50% spinal canal narrowing, resulting in considerable improvement. The above results support the hypothesis that a correlation exists between the magnitude of the spinal canal encroachment, the initial neurological deficit and the final outcome.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allen AR (1911) Surgery of experimental lesion of spinal cord equivalent to crush injury of fracture dislocation of spinal column. JAMA 57:878–884
Bolman H (1979) Acute fractures and dislocations of the cervical spine. J Bone Joint Surg [Am] 61:1119–1142
Bolman HH, Bahniuk E, Raskulinecr G (1981) Incomplete cervical spinal cord injury. Spine 6:428–433
Dohrmann GJ, Allen WE III (1975) Microcirculation of traumatised spinal cord: a correlation of microangiography and blood flow patterns in transitory and permanent paraplegia. J Trauma 15:1003–1007
Dohrmann GJ, Wagner FC Jr, Bucy PC (1971) The microvasculate in transitory traumatic paraplegia: an electron microscopic study in the monkey. J Neurosurg 35:263–268
Dohrmann GJ, Panjabi MM (1976) Standardised spinal cord trauma: biomechanical parameters and lesion volume. Surg Neurol 6:263–267
Eismont FJ, Clifford S, Goldberg M, Green B (1984) Cervical sagittal spinal canal size in spine injury. Spine 9:663–666
Frankel HL et al (1969) The value of postural reduction on the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7:179–193
Gertzbein SD, Court-Brown CM, Marks P, Martin C, Fazl M, Schwartz M, Jacobs RR (1988) The neurological outcome following surgery for spinal fractures. Spine 13:641–644
Green BA, Wagner FC Jr (1973) Evolution of oedema in the acutely injured spinal cord. A fluorescence microscopic study. Surg Neurol 1:98–102
Kamiya T (1967) Experimental study on anterior spinal cord compression with special emphasis on vascular disturbance. Nagoya J Med Sci 31:171–175
Kiwerski JE (1992) Respiratory problems in patients with quadriplegia after a high lesion of the cervical spinal cord. Int J Rehabil Res 15
Kiwerski JE (1993) Traumatic lesions of the lower cervical spine in Poland. Eur Spine J 2:42–45
Korres DS (1993) Injuries of the cervical spine. Litsas, Athens
McMichan JC, Michel J, Westbrook RR (1980) Pulmonary dysfunction following traumatic quadriplegia. JAMA 243:528–535
Raynor RB, Koplik B (1985) Cervical cord trauma: the relationship between clinical syndromes and force of injury. Spine 10:193–197
Robinson RA (1978) Approaches to the cervical spine C1-T1. In: Schmidek HH, Sweet WH (eds) Current techniques in orthopaedic neurosurgery. Grune & Stratton, New York, pp 205–302
Schneider RC (1955) The syndrome of acute anterior spinal cord injury. J Neurosurg 19:95–99
Schneider RC, Thompson JM, Bebin J (1958) The syndrome of acute central cervical cord injury. J Neurol Neurosurg Psychiatry 21:216–220
Smith MD, Bolesta MJ (1992) Oesophageal perforation after anterior cervical plate fixation. J Spinal Disord 5:357–362
Tarlov JM (1954) Spinal cord compression studies. III. Time limits for recovery after gradual compression in dogs. Arch Neurol Psychiatry 71:588–592
Tarlov JM, Klinger H, Vitale S (1953) Spinal cord compression studies. I. Experimental techniques to produce acute and gradual compression. Arch Neurol Psychiatry 70:813–817
Tencer AF, Allen BL, Ferguson RL (1985) A biomechanical study of thoracolumbar spinal fractures with bone in the canal. I. The effect of laminectomy. Spine. 10:580–585
Tencer AF, Allen BL, Ferguson RL (1985) A biomechanical study of thoracolumbar spinal fractures with bone in the canal. III. Mechanical properties of the dura and its tethering ligaments. Spine 10:741–747
Tencer AF, Ferguson RL, Allen BL (1985) A biomechanical study of thoracolumbar spinal fractures with bone in the canal. II. The effect of flexion angulation, distraction and shortening of the motion segment. Spine 10:586–589
Turnbull JM (1971) Mlorovasculature of the human spinal cord. J Neurosurg 35:141–146
Wagner RF, Abel MS (1960) Small-element lesion of the cervical spine due to trauma. Clin Orthop 16:235–238
Wagner FC Jr, Dohrmann GJ (1975) Alterations in nerve cells and myelinated fibres in spinal cord injury. Surg Neurol 3:175–178
Wagner FC Jr, Dohrmann GJ, Bucy PC (1970) Early alterations in spinal cord morphology following experimental trauma. Fed Proc 29:289–294
Yee GKH, Terry AF (1993) Oesophageal penetration by an anterior cervical fixation device. Spine 18:522–527
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sapkas, G., Korres, D., Babis, G.C. et al. Correlation of spinal canal post-traumatic encroachment and neurological deficit in burst fractures of the lower cervical spine (C3–7). Eur Spine J 4, 39–44 (1995). https://doi.org/10.1007/BF00298417
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00298417