Abstract | STUDY DESIGN: Report of a rare fracture of the cervical spine. OBJECTIVES: To illustrate the importance of the cervical spinolaminar line in the diagnosis of this unusual injury and to comment on appropriate investigations, management, and outcome. SUMMARY OF BACKGROUND DATA: Laminar fractures of the cervical spine are uncommon and are often missed. They usually occur after a hyperextension injury. It is unusual for these injuries to cause neurologic compromise. The injury reported here differs in that it was a result of direct trauma to the posterior aspect of the neck, and there was a significant neurologic deficit. METHODS: The clinical findings, roentgenographic appearance, treatment, complications, and follow-up assessment are presented and discussed. RESULTS: Initial neurologic examination revealed a right hemiparesis. Radiographs showed disruption of the spinolaminar line at C5 and a computed tomography scan revealed a fracture of the lamina of C5 with spinal canal encroachment. Management included high-dose corticosteroid administration and a posterior spinal decompression. The patient's initial postoperative course was complicated by acute pulmonary edema, which responded well to intravenous Furosemide and ventilation. Follow-up assessment showed significant neurologic improvement. CONCLUSIONS: The satisfactory outcome in the case of this rare injury was the result of a prompt, accurate diagnosis and appropriate management.
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Authors | P Makan |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 24
Issue 11
Pg. 1144-6
(Jun 01 1999)
ISSN: 0362-2436 [Print] United States |
PMID | 10361665
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Glucocorticoids
- Furosemide
- Methylprednisolone
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Topics |
- Adult
- Cervical Vertebrae
(injuries, surgery)
- Decompression, Surgical
- Follow-Up Studies
- Furosemide
(therapeutic use)
- Glucocorticoids
(therapeutic use)
- Hemiplegia
(diagnostic imaging, etiology, therapy)
- Humans
- Male
- Methylprednisolone
(therapeutic use)
- Muscle, Skeletal
(innervation, physiopathology)
- Nervous System Diseases
(diagnostic imaging, etiology, therapy)
- Pulmonary Edema
(therapy)
- Pulmonary Ventilation
- Spinal Fractures
(complications, diagnostic imaging, therapy)
- Tomography, X-Ray Computed
- Treatment Outcome
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