title: Management of delayed posttraumatic cervical kyphosis.
abstract: We describe three patients with misdiagnosed unstable fractures of the cervical spine, who were treated conservatively and developed kyphotic deformity, myelopathy, and radiculopathy. All three patients were then managed with closed reductions by crown halo traction, followed by instrumented fusions. Their neurologic function was regained without permanent disability in any patient. Unstable fractures of the cervical spine will progress to catastrophic neurologic injuries without surgical fixation. Posttraumatic kyphosis and the delayed reduction of partially healed fracture dislocations by preoperative traction are not well characterized in the subaxial cervical spine. The complete evaluation of any subaxial cervical spine fracture requires CT scanning to assess for bony fractures, and MRI to assess for ligamentous injury. This allows for assessment of the degree of instability and appropriate management. In patients with delayed posttraumatic cervical kyphosis, preoperative closed reduction provided adequate realignment, facilitating subsequent operative stabilization.
authors: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Suite 2210, 676 North Saint Clair Street, Chicago, IL 60611, USA.
authors: Alejandro J
authors: AJ
authors: Lopez
authors: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Suite 2210, 676 North Saint Clair Street, Chicago, IL 60611, USA.
authors: Justin K
authors: JK
authors: Scheer
authors: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Carver School of Medicine, Iowa City, IA, USA.
authors: Kingsley
authors: K
authors: Abode-Iyamah
authors: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Suite 2210, 676 North Saint Clair Street, Chicago, IL 60611, USA.
authors: Zachary A
authors: ZA
authors: Smith
authors: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Carver School of Medicine, Iowa City, IA, USA.
authors: Patrick W
authors: PW
authors: Hitchon
authors: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Suite 2210, 676 North Saint Clair Street, Chicago, IL 60611, USA. Electronic address: nader.dahdaleh@northwestern.edu.
authors: Nader S
authors: NS
authors: Dahdaleh
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D019468:Disease Management; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Cervical fracture; Kyphosis; Post traumatic kyphosis; Traction; Unstable cervical fractures