Traumatic Enucleation of the Body of the Sixth Cervical Vertebra Without Neurologic Sequelae

Abstract

Case report of an adult man with traumatic enucleation of the body of the sixth cervical vertebra with initial minimal neurologic damage and without vascular injury, which was successfully treated with surgery. To describe the traumatic mechanism, diagnostic procedures, operative findings, and adopted management. Literature review suggests that the observed case is exceptional. Similar vertebral injuries are usually associated with severe neurologic and vascular damages. A 38-year-old farmer with enucleation of the body of the sixth cervical vertebra was admitted to the Orthopedic Clinic of Padua University. The patient initially was treated with halo traction. Two days later, he underwent anterior open reduction and internal fixation with plate. He was discharged 2 months later with a halo vest. Two years after surgery, the pedicles' fracture had healed solidly with normal intervertebral alignment and a slight loss of the height of the C6-C7 intervertebral space (fibrous union). He is asymptomatic and has totally resumed his habitual work. Traumatic enucleation of the body of a lower cervical vertebra is a rare injury. The case presented here demonstrates that such a lesion can be less severe than a complete dislocation or a burst fracture. The good outcome of surgery suggests that the treatment adopted was effective, although an interbody fusion would have been more adherent to conventional surgical principles.