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Neurologic compromise after an isolated laminar fracture of the cervical spine.

AbstractSTUDY 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.
AuthorsP Makan
JournalSpine (Spine (Phila Pa 1976)) Vol. 24 Issue 11 Pg. 1144-6 (Jun 01 1999) ISSN: 0362-2436 [Print] United States
PMID10361665 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Glucocorticoids
  • Furosemide
  • Methylprednisolone
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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