title: Rare case of survival after traumatic disruption of the cervical spine with combined complete spinal cord injury and bilateral vertebral arterial breakdown in an 18-month-old patient.
abstract: Complete cervical disruption is a rare and lethal injury secondary to high-energy trauma. Bilateral vertebral arterial breakdown is also a rare and lethal injury. This is the first reported clinical case of an 18-month-old girl who survived after combined cervical spinal cord disruption and bilateral vertebral arterial breakdown. Although she developed cardiopulmonary arrest at the accident site, resuscitation by a bystander, early fluid resuscitation, appropriate respiratory management, and subsequent surgical stabilization resulted in survival and preservation of higher cortical functions. She underwent surgery 1 week after hospitalization; her cervical spine was stabilized by posterior fixation using pedicle screws and transarticular screws. After the operation, the burst vertebra was gradually remodeled. Approximately 4 months later, she was transferred to a rehabilitation facility. Ten years later, she is attending to an elementary school, and she is able to speak and operate a wheelchair using a portable respiratory organ. We herein report an exceedingly rare case of cervical cord injury involving a combination of disruption of the cervical spine and bilateral vertebral arterial breakdown in a young child.
authors.affiliation: Department of Orthopedic Surgery, Wakayama Rosai Hospital, 93-3, Kinomoto, Wakayama City, Wakayama, 640-8505, Japan, tkj-matsumoto@wakayamah.rofuku.go.jp.
authors.forename: Takuji
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kawakami
authors.forename: Muneharu
authors.initials: M
authors.lastname: Ando
authors.forename: Munehito
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000063:Accidents, Traffic; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007223:Infant; D065289:Pedicle Screws; D011782:Quadriplegia / Q000209:etiology; D013119:Spinal Cord Injuries / Q000209:etiology* / Q000601:surgery; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery; D017741:Survivors; D020217:Vertebral Artery Dissection / Q000209:etiology*
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