![]() She was immediately intubated, transport cervical immobilization was applied, supportive therapy was administered, and the patient was transported to the University Clinical Center of Serbia Emergency Center in Belgrade, which is the main trauma center in Serbia.Ĭomputed tomography revealed complete traumatic dislocation of C6/C7 with consequent transection of the spinal cord ( Figs 1 and 2).Ĭervical spine X-ray postoperatively – lateral view: properly positioned osteosynthesis material. Case presentationĪ 22-year-old female patient was injured in a traffic accident while riding in the front passenger seat of a car. We present a case of extreme traumatic dislocation at the C6/C7 level with complete transection of the spinal cord, in a young girl who was riding in a car as a front seat passenger. The most common mechanism of traumatic cervical vertebrae dislocation is hyperextension or hyperflexion with distraction, which occurs most often in traffic accidents. Recovery from neurological deficit is uncertain, even after the administration of appropriate medication and surgical treatment. Cervical spine injuries can be roughly categorized as axial spine injuries (occiput, C1 and C2), and the children are prone to suffer dislocation at this level, and subaxial spine injuries (C3–C7), where traumatic dislocations occur more common. The severity of the injury and treatment depends on injury and patient related factors. I think they are really helpful.Traumatic C6/C7 dislocation, transection of the spinal cord, timing of the surgical procedure, surgical approach Introductionĭue to its particular anatomy (mobility) and function, the cervical spine is subject to a variety of injuries, from muscle strains to complete dislocation, while a significant number of injuries are associated with spinal cord injury and resulting neurological deficit. So if you ask the MRI facility that you normally use or you have one yourself, I would really suggest distinguishing yourself from the rest of the units in your area by supplying oblique MRI views of the cervical spine. I think this is a much better representation of the size and how much this disc extrusion occupies the foraminal canal than a standard axial view. And if we take a look at the obliques of the foraminal canal, this is given a much larger appearance of the disc extrusion, and where we’re going to see it located is right there. Now look at how much larger this appears here at the 5/6th level with the oblique views. Let’s just take a look and see what happens when we take a look at an oblique picture. So I don’t think this is such a great revelation in terms of what’s happening in the Foraminal Canal. The radiologists have better equipment and magnification and resolution than I do on this reader, but I have probably the typical kind of reader that most of you all might have as well. And if you keep going again, everything sort of disappears. We can see it’s again smaller, but not really that big. We take a look at the axial slice, and we don’t really get a great sense of how big it is here. However, if you go to the sides, for example, we can see this protrusion here. Well, it’s got a little bit of protrusion and maybe a little indentation of the myelin, but nothing to write home about. In this case, we have a definite protrusion at cervical 5/6, and we can see it’s here, but we don’t really get a true sense of dimension using the the axial slices. One of the challenges when looking at cervical MRIs is really getting a proper look at the foraminal canals, particularly at the cervical levels 3/4 4/5 5/6, and even 6/7.
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