Multiple unstable cervical fractures with cord compromise treated nonoperatively: a case report.
METHODS
The case of a 17-year-old boy who sustained an unusual pattern of multiple unstable cervical spine fractures with a spinal cord injury is presented.


OBJECTIVE
To review the management and treatment of multiple unstable cervical spine fractures. SUMMARY OF BACKGROUND DATA.: Combined unstable cervical spine injuries are uncommon. Treatment of multiple-level cervical spine fractures remains controversial.


METHODS
The case of a 17-year-old boy who sustained a ring fracture of the atlas, an atypical traumatic spondylolisthesis of the axis, bilateral pedicle fractures of C3 with significant anterior subluxation of C3 on C4, a C6 burst fracture, compression fractures of C7 and T1, and significant cord compression as the result of a motor vehicle accident is presented.


RESULTS
The patient was successfully treated with an initial closed reduction using cervical traction for 1 week followed by placement of a cervical halo vest. The fractures healed successfully, and the patient regained near-normal neurologic function.


CONCLUSIONS
Despite advances in the surgical treatment of cervical fractures and dislocations, nonoperative treatment with halo immobilization remains a viable option for selected complex injury patterns.
Tannoury
Tony Y
TY
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA. ttannoury@msn.com
Zmurko
Matthew G
MG
Tannoury
Chadi A
CA
Anderson
D Greg
DG
Chan
Donald P K
DP
D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000628:therapy*; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*