Traumatic Fracture dislocation ~Cervico thoracic spine

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Traumatic Fracture dislocation Cervico thoracic
spine

• Manoj Krishna,Spinal Surgeon
• Shailesh Hadgaonkar,Spinal Fellow
• Stockton on tees, Cleveland.

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Story

• 45 yr / m , admiutted to A E with
• h/o fall from 15 feet
• Pt. was immobilised primarily in cervical collar
• C/o neck pain, radiation to Rt.U /E,numbness of
  Rt. Hand.
• Nil Neurogical.

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X rays done- reported as normal
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C7-T1 Fracture dislocation-Bilateral facet
dislocation

• Swimmers view

• CT sag

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Sag MR scan

• Severe unstability

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Post op X ray

• Surgery-open rednACDF

• Sagital balance

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CT Scan- Stable fixn stable spine

• Reduction -lysthesis,no comp.

• Reduction of facet dislocation

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Learning Points

• Suspect severe neck injury if the mechanism of
  injury is severe
• Xrays are unreliable- get a CT scan in high risk
  cases
• Early fixation critical
• This patient is now fully recovered.
• If we had missed it he would have been paralysed.

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