Hemiparesis resulting from an unusual C1 fracture: A case report and literature review.

C1 Central cord syndrome Cervical fracture Jefferson fracture

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2020
Historique:
received: 30 07 2020
accepted: 01 12 2020
entrez: 7 1 2021
pubmed: 8 1 2021
medline: 8 1 2021
Statut: epublish

Résumé

Jefferson fractures are burst fractures involving both the anterior and posterior arches of C1. They typically result from axial compression or hyperextension injuries. Most are stable, and neurological deficits are rare. They are often successfully treated with external immobilization, but require surgery (e.g., fusion/ stabilization). An 89-year-old male presented with a left-sided hemiplegia following a trivial fall. The cervical computed tomography scan revealed a left-sided displaced comminuted C1 fracture involving the arch and lateral mass. The MR revealed posterior cord compression and focal myelomalacia. Six months following an emergent C1-C3 decompression with occiput to C4 instrumented fusion, the patient was neurologically intact and pain-free. An 89-year-old male presented with a left-sided hemiplegia due to a Type 3/4 C1 Jefferson fracture. Following posterior C1-C3 surgical decompression with C0-C4 instrumented fusion, the patient sustained a complete bilateral motor recovery.

Sections du résumé

BACKGROUND BACKGROUND
Jefferson fractures are burst fractures involving both the anterior and posterior arches of C1. They typically result from axial compression or hyperextension injuries. Most are stable, and neurological deficits are rare. They are often successfully treated with external immobilization, but require surgery (e.g., fusion/ stabilization).
CASE DESCRIPTION METHODS
An 89-year-old male presented with a left-sided hemiplegia following a trivial fall. The cervical computed tomography scan revealed a left-sided displaced comminuted C1 fracture involving the arch and lateral mass. The MR revealed posterior cord compression and focal myelomalacia. Six months following an emergent C1-C3 decompression with occiput to C4 instrumented fusion, the patient was neurologically intact and pain-free.
CONCLUSION CONCLUSIONS
An 89-year-old male presented with a left-sided hemiplegia due to a Type 3/4 C1 Jefferson fracture. Following posterior C1-C3 surgical decompression with C0-C4 instrumented fusion, the patient sustained a complete bilateral motor recovery.

Identifiants

pubmed: 33408934
doi: 10.25259/SNI_479_2020
pii: SNI-11-449
pmc: PMC7771413
doi:

Types de publication

Case Reports

Langues

eng

Pagination

449

Informations de copyright

Copyright: © 2020 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

Int J Spine Surg. 2019 Aug 31;13(4):345-349
pubmed: 31531284
Orthop Traumatol Surg Res. 2018 Nov;104(7):1049-1054
pubmed: 30193984
Clin Orthop Relat Res. 2008 May;466(5):1257-61
pubmed: 18259828
J Neurosurg Spine. 2009 May;10(5):466-73
pubmed: 19442009
Neurosurgery. 2013 Mar;72 Suppl 2:127-31
pubmed: 23417185
Clinics (Sao Paulo). 2013 Nov;68(11):1455-61
pubmed: 24270959
Indian J Orthop. 2017 Jan-Feb;51(1):28-35
pubmed: 28216748

Auteurs

Sung-Joo Yuh (SJ)

Department of Neurosurgery, Hopital Maisonneuve-Rosemont, Québec, Canada.
Department ofNeurosurgery, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Zhi Wang (Z)

Department of Orthopedics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Ghassan Boubez (G)

Department of Orthopedics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Daniel Shedid (D)

Department ofNeurosurgery, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Classifications MeSH