Traumatic Fracture: Dislocation of Cervicothoracic Junction—Grand Round Presentation of C7-T1 Instabilities and Different Instrumentation Techniques

Mohammad A Alsofyani,Sreenath Jakinapally,Louis Boissière,Sultan Alsalmi,Ibrahim Obeid,Soufiane Ghailane,Jean-Marc Vital

doi:10.1155/2020/7578628

Abstract

Introduction Acute traumatic cervicothoracic junction spinal lesions are rare disorders and poorly documented. We report a case of a traumatic cervicothoracic fracture-dislocation. We present our experience in the operative treatment of an unstable fracture-dislocation at the cervicothoracic junction. Materials and Method. A seventy-year-old man was transferred to our hospital. We found paresthesia in the corresponding dermatome of C7 and C8 bilaterally. Initial CT scan shows vertebral body fracture of T1 with retropulsion into the spinal canal and anteroposterior dislocation of cervicothoracic junction type C according to AOSpine subaxial injury. Traumatic disc material at C7-T1 was removed by anterior cervical discectomy and fusion of C6-T2. Fixation was done from C6 to T2 in the prone position. Results At one-year postoperative follow-up, radiographs revealed bony fusion at the level of C7-T1, and the patient had no major functional disability. Conclusion We opted for the ventral-dorsal approach in our case for maximum stabilization and to prevent mechanical complications.

Highlights

Acute traumatic cervicothoracic junction spinal lesions are rare disorders and poorly documented
In cervicothoracic junction (CTJ) injuries, surgical techniques and associated complications have been extensively described in the literature during the past decade, whereas the choice of anterior versus posterior or doublestage fixation has been given little attention [1,2,3]
The initial Glasgow Coma Scale score was 15. He was hemodynamically stable and breathing spontaneously; we found paresthesia corresponding with dermatomes C7 and C8 bilaterally

Summary

Introduction

Traumatic injuries at the cervicothoracic junction (CTJ) are a relatively rare event and considered as a significant cause of paraparesis or paraplegia posttraumatic. As young people are most commonly injured, it is considered as a significant economic burden to the family and society. In CTJ injuries, surgical techniques and associated complications have been extensively described in the literature during the past decade, whereas the choice of anterior versus posterior or doublestage fixation has been given little attention [1,2,3]. The purpose of this study is to discuss different instrumentation techniques of this rare injury

Case Presentation

Findings

Discussion