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.
References
Allen BL Jr, Ferguson RL, Lehmann TR, O’Brien RP (1982) A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine 7:1–27
Bohlman HH (1979) Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am 61:1119–1142
Cimmino CV, Scott DW (1977) Laminar avulsion in a cervical vertebra. AJR Am J Roentgenol 129:57–60
De Barros Filho TE, De Mendonca AB (1990) Fracture of the lamina of the sixth cervical vertebra with quadriplegia. A case report. Spine 15:220–222
Hahnle UR, Nainkin L (2000) Traumatic invagination of the fourth and fifth cervical laminae with acute hemiparesis. J Bone Joint Surg Br 82:1148–1150
Makan P (1999) Neurologic compromise after an isolated laminar fracture of the cervical spine. Spine 24:1144–1146
Motomochi M, Makita Y, Nabeshima S, Itagaki T (1981) Tei T [case report of acute central cervical cord injury with C7 laminar fracture and extradural hematoma (author’s transl)]. No Shinkei Geka 9:191–194
Argenson C, Lovet J, Sanouiller JL, de Peretti F (2013) Traumatic rotatory displacement of the lower cervical spine. Spine 13:767–773
Fehlings MG, Perrin RG (2006) The timing of surgical intervention in the treatment of spinal cord injury: a systematic review of recent clinical evidence. Spine 31:S28–S35 (discussion S6)
McKinley W, Meade MA, Kirshblum S, Barnard B (2004) Outcomes of early surgical management versus late or no surgical intervention after acute spinal cord injury. Arch Phys Med Rehabil 85:1818–1825
Cadotte DW, Singh A, Fehlings MG (2010) The timing of surgical decompression for spinal cord injury. F1000 Med Rep 2:67
Carlson GD, Minato Y, Okada A, Gorden CD, Warden KE, Barbeau JM et al (1997) Early time-dependent decompression for spinal cord injury: vascular mechanisms of recovery. J Neurotrauma 14:951–962
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Bourghli, A., Ribes, C., Obeid, I. et al. Complete fracture of the lamina of the sixth cervical vertebra with hemiplegia: a case report. Eur Spine J 25 (Suppl 1), 49–52 (2016). https://doi.org/10.1007/s00586-015-4067-y
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DOI: https://doi.org/10.1007/s00586-015-4067-y