Cervical Spinal Cord Compression Research Articles

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain.

Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation.Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space.The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased.The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.

Prevalence and Predictive Factors of Concurrent Cervical Spinal Cord Compression in Adult Spinal Deformity.

Retrospective cross-sectional cohort. To investigate the prevalence and predictive factors of concurrent cervical spinal cord compression (CSCC) in patients with adult spinal deformity (ASD). In patients with ASD undergoing major thoracolumbar realignment surgery, concurrent CSCC potentially increases the risk of progression of myelopathy or cervical cord injury due to various perioperative factors including poor intraoperative neck positioning and hypotension. However, the prevalence of CSCC in ASD patients has not been previously studied. This study included ASD patients who were indicated for major thoracolumbar corrective surgery (>5 levels). The presence of CSCC was determined using the modified Cord Compression Index (Grades 0-3) based on the cervical magnetic resonance imaging (MRI). Significant CSCC was defined as Grade>2, and the distribution of compression level as well as the number of Grade>2 segments were investigated in each patient. A multivariate regression analysis was performed to identify the predictors of CSCC with variables being the patients' characteristics including radiographic sagittal alignment parameters. Of 121 patients with ASD, 41 patients (33.8%) demonstrated significant CSCC on MRI. Intramedullary T2 hyper-intensity (myelomalacia) was present in eight patients (6.6%). Thirty-five of 41 patients were asymptomatic or with myelopathy that is difficult to detect. Significant CSCC was most commonly observed at C4/5 level. Four patients (3.3%) underwent cervical decompression and fusion prior to thoracolumbar reconstruction. Multivariate regression analysis revealed old age, increased body mass index (BMI), and PI-LL mismatch independently predicted the CSCC grade. The prevalence of concurrent significant cervical cord compression in patients with ASD is relatively high at 33.8%. Preoperative evaluation of cervical MRI and examinations for signs/symptoms of myelopathy are essential for patients with (1) older age, (2) increased BMI, and (3) high PI-LL mismatch to avoid progressive myelopathy or cord injury during ASD surgery. 4.

Radiologic Assessment of Cervical Canal Stenosis Using Kang MRI Grading System: Do Clinical Symptoms Correlate with Imaging Findings?

IntroductionMagnetic resonance imaging (MRI) is widely used in the evaluation of cervical canal stenosis and spinal cord compression. Kang et al. formulated a new MRI grading system for assessing canal stenosis which takes cord signal change into account. The purpose of the study was to determine the agreement between Kang's grading system and neurological symptoms.Methods A cross-sectional study was conducted at Aga Khan University Hospital between April 2014 and December 2015. Patients meeting inclusion criteria were enrolled. T2 sagittal and T2 axial MRI images were acquired and reported by a consultant neuroradiologist, in accordance with the MRI grading system suggested by Kang et al. Neurologic clinical symptoms were acquired by the history taken by the principal investigator. More than one neurologic symptoms and Kang MRI grade 2 or 3 were taken as positive evidence of cord compression resulting from canal stenosis.ResultsAmongst 126 subjects, 54% were females. Mean age of patients was 50.3 ± 14.3 years (range 19-83 years). Average disease duration was 4.61 ± 3.73 (range 1-24 months). In the majority of the patients, the findings were found at the C5-C6 level. 65.1% of patients were identified positive for cervical canal stenosis by Kang grading system. Most common neurological symptoms were pain (99%) and numbness (56%). Cohen’s Kappa was run to evaluate the agreement between neurological symptoms and Kang grading system. There was a strong agreement between the two methods, K = 0.81 (95% CI 0.70-0.92), p < 0.001.ConclusionThere was a substantial agreement between Kang's grading system and the presence of clinical symptoms. The agreement was greatest in females, older patients, and those with longer duration of symptoms.

A Clinical Correlation Research of the Hoffmann Sign and Neurological Imaging Findings in Cervical Spinal Cord Compression

The Hoffmann sign is usually used as an indicator of upper motor neuron lesion, but its clinical effect remains controversial in previous reports. A retrospective case control study including 107 patients with cervical complaints was carried out. According to the presence of Hoffmann sign, patients were divided into 2 groups. The radiographic results were assessed and the sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology, segment, cervical spine canal ratio, and S-index were calculated. There were 56 patients in the positive Hoffmann group and 51 patients in negative group. The sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology were found to be 61.6%, 85.7%, 94.6%, 35.3%, 14.3%, 38.4% and 60.5%, 81.0%, 92.9%, 33.3%, 19.0%, 39.5%, respectively. The ratio of cervical spine canal was lower in the positive Hoffmann group than in control group. Although the Hoffmann sign is not foolproof in the diagnosis of cervical spinal cord compression, it can be used to assess symptomatic patients. The narrower the cervical spine canal or the higher the cervical segment compression, the higher of the incidence of positive Hoffmann sign.

Ollier Disease at the Origin of a Cervical Spinal Cord Compression: About a Case and Review of Literature

Ollier Disease at the Origin of a Cervical Spinal Cord Compression: About a Case and Review of Literature

Intradural extramedullary cystic schwannoma of the cervical spine

Giant cervical intradural extramedullary schwannoma with severe spinal cord compression is a rare entity. Tumor spread and size are very important for surgical approach. In this case, we report a 55-years-old male patient with a giant intradural-extramedullary cervical schwannoma extending between C5 and T1 and causing spinal cord compression that underwent total resection with laminoplasty at C5-6-7 levels. The patient developed no additional deficit. To preserve the cervical lordosis, the patient used a cervical collar for three months. There has been no recurrence during two years of follow-up. Using the appropriate surgical method is essential in patients with spinal tumor in order to avoid additional neurological deficits and achieve cure.

The correlation between hypoxia-inducible factor-1α, matrix metalloproteinase-9 and functional recovery following chronic spinal cord compression

The molecular mechanisms underlying cervical spondylotic myelopathy (CSM) are poorly understood. To assess the correlation between HIF-1α, MMP-9 and functional recovery following chronic cervical spinal cord compression (CSCI). Rats in the sham group underwent C5 semi-laminectomy, while a water-absorbable polyurethane polymer was implanted into the C6 epidural space in the chronic CSCI group. Basso, Beattie and Bresnahan score and somatosensory evoked potentials were used to evaluate neurological function. Hematoxylin and eosin staining was performed to assess pathological changes in the spinal cord, while immunohistochemical analysis was used to examine HIF-1α and MMP-9 expression on days 7, 28, 42 and 70 post-surgery. Normal rats were only used for HE staining. The BBB score was significantly reduced on day 28 following CSCI, while SEPs exhibited decreased amplitude and increased latency. In chronic CSCI group, the BBB score and SEPs significantly improved on day 70 compared with day 28. HE staining revealed different level of spinal cord edema after chronic CSCI. Compared with the sham group, immunohistochemical analyses revealed that HIF-1α- and MMP-9-positive cells were increased on day 7 and peaked on day 28. HIF-1α and MMP-9 expression were demonstrated to be significantly positively correlated, whereas HIF-1α expression and BBB score were significantly negatively correlated, as well MMP-9 expression and BBB score. HIF-1α and MMP-9 expression are increased following chronic spinal cord compression and are positively correlated with one another. Decreased expression of HIF-1α and MMP-9 may contribute to functional recovery following CSCI. This expression pattern of HIF-1α and MMP-9 may give a new perspective on the molecular mechanisms of CSM.

Should Asymptomatic Patients With Cervical Spinal Cord Compression and Spinal Cord Signal Change Undergo Surgical Intervention?

Should Asymptomatic Patients With Cervical Spinal Cord Compression and Spinal Cord Signal Change Undergo Surgical Intervention?

Prospective Analysis of Functional Outcome of Single-Stage Surgical Treatment for Symptomatic Tandem Spinal Stenosis.

Background:Tandem spinal stenosis (TSS) is a rare presentation leading to combined clinical features of upper motor neuron and lower motor neuron lesion which includes intermittent neurogenic claudication with or without neurological deficit, progressive gait imbalance and gait disturbances. In literature, there is controversy whether stage surgery or single-stage surgery should be done.Materials and Methods:From June 2009 to November 2016 in a series of 1381 patients who underwent surgery for various degenerative spinal conditions, 82 patients were diagnosed with having symptomatic TSS with an incidence of 5.93%. All patients diagnosed with TSS underwent single-stage surgical intervention by one surgical team. The perioperative factors were recorded for each patient. All patients were evaluated preoperatively and postoperatively at each followup with the modified Japanese Orthopaedic Association (mJOA) score, Nurick's grading, Oswestry disability index (ODI) and Cooper scale.Results:In this study, 82 patients including 70 males and 12 females underwent simultaneous surgical intervention for symptomatic TSS. The mean age of patients was 61.78 ± 10.48 years. There was a significant improvement in mJOA score, Nuricks grading, ODI and Coopers scale postoperatively as compared to preoperative values (P < 0.05).Conclusion:Symptomatic TSS can be safely managed by single-stage surgical intervention with good postoperative results or without a significant increase in complication rates. Single-stage surgical intervention helps to relieve the symptoms of both cervical and lumbar spinal cord compression, avoids the risk of repeated anesthesia, reduce the duration of surgery, repeated hospitalization hence, reducing the cost for hospitalization and also reducing the rehabilitation, recuperation time and early functional recovery justifies single-stage surgical intervention.

Cervical spinal cord compression in infants with achondroplasia: should neuroimaging be routine?

PurposeTo examine results of magnetic resonance imaging (MRI), polysomnograms (PSG), and patient outcomes in patients with achondroplasia in light of recent screening recommendations for infants with achondroplasia. MethodsWe reviewed medical records of 49 patients with achondroplasia followed at our institution between September 1997 and January 2017, including physical exams, MRIs, PSGs (when available), and surgical histories. Appropriate PSG data were available for 39 of these patients. ResultsTwenty-seven of 49 patients had cervical cord compression on MRI, and 20 of those patients required surgery. Central apnea was detected in 2/23 patients with cervical cord compression in whom PSG data was available. Physical exam revealed depressed deep-tendon reflexes in two patients with cord compression and one patient without cord compression. Besides hypotonia in some, the neurological exams of these patients were unremarkable. ConclusionsCervical cord compression is a common occurrence in infants with achondroplasia and necessitates surgical intervention in some patients. Physical exam and PSG are poor predictors of the presence of cord compression or the need for surgery. All infants with achondroplasia should have MRIs of the craniocervical junction in the first 6 months of life.

Anterior surgical options for cervical spondylotic myelopathy

Cervical spondylotic myelopathy (CSM) is one of the most common among causes of spinal cord dysfunction worldwide. In this article, we provide a broad narrative review of the options to treat CSM from an anterior approach to the cervical spine. Anterior procedures are effective and safe, especially for one or two level disease (although can be used up to 7-8 levels). This approach can be used in patients with lordotic, neutral, or kyphotic cervical spine alignment and provide excellent access for direct neural decompression. The most common adverse effects of anterior cervical operations are dysphagia and dysphonia, but fortunately, these are mild and transient in the majority of cases. Severe complications, such as vertebral arterial injury, spinal cord injury or airway compromise, are rare but must be taken into consideration, especially when additional risk factors are present (multilevel procedures, revision surgeries, older, and infirm patients). The primary anterior cervical procedures for treating CSM are anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), oblique cervical corpectomy, and cervical disc arthroplasty. A combination (hybrid) of ACDF and ACCF is also utilized as an option to allow for wide decompression, deformity correction, and provide more surface area of exposed, and bleeding cancellous bone. More recently, the senior author (KDR) has utilized a hemi-corpectomy and fusion hybrid technique which will be described in this text. Advantages and disadvantages of each of these options are discussed in detail, as well as the need for posterior instrumentation supplementation in selected patients; such as those with concomitant cervical deformity, poor bone quality, or those at risk for pseudarthrosis following multilevel arthrodeses. The management of patients with cervical spinal cord compression without myelopathy or with mild symptoms is also discussed.

Clinical outcomes and risk factors in patients with cervical metastatic spinal cord compression after posterior decompressive and spinal stabilization surgery.

PurposeThe aim of this study was to investigate the clinical results of surgery for cervical spine metastasis and identify clinical risk factors affecting postoperative survival and neurological outcome.Patients and methodsA retrospective analysis of medical records was performed on 19 patients who had undergone decompressive surgery and spine stabilization due to metastatic spinal cord compression in the cervical spine. All patients had severe pain before surgery. Worst pain, average pain, and pain interference were evaluated using the visual analog scale (range, 0–10) for each patient at baseline and following surgery. Neurological recovery was assessed using the Japanese Orthopaedic Association Score (JOAS). In addition, associations between ten characteristics and postoperative survival and neurological outcomes were analyzed in the study.ResultsThe mean worst pain score in a 24-hour period was 8.6 before the operation. At 1 day, 1, 3, 6, and 12 months after the operation, the mean worst pain scores decreased to 5.6, 4.5, 3.8, 2.6, and 2.4 (all P<0.001 vs baseline), respectively. Similar decreases in average pain and pain interference were also observed. The median JOAS in a 24-hour period was 11.0 before the operation. At 1 day, 1, 3, 6, and 12 months after the operation, the median JOAS increased to 12.0 (P=0.469), 13.0 (P=0.010), 14.0 (P<0.001), 15.0 (P<0.001), and 14.0 (P<0.001), respectively. According to the multivariate analysis, postoperative survival was significantly associated with the type of primary tumor (P=0.033), preoperative ambulatory status (P=0.004), extra-spinal bone metastasis (P=0.021), 125I seed brachytherapy (P=0.014), and complication status (P=0.009). Better neurological outcome was found to be correlated with higher JOAS (P=0.013). Surgery-related complications occurred in 26.3% of patients.ConclusionPosterior decompression and spine stabilization for painful cervical spine metastasis resulting from spinal cord compression were found to be effective for neurological recovery and pain control with a tolerable rate of complications.

Long-term outcomes of systemic therapies for Hurler syndrome: an international multicenter comparison

PurposeEarly treatment is critical for mucopolysaccharidosis type I (MPS I), justifying its incorporation into newborn screening. Enzyme replacement therapy (ERT) treats MPS I, yet presumptions that ERT cannot penetrate the blood–brain barrier (BBB) support recommendations that hematopoietic cell transplantation (HCT) treat the severe, neurodegenerative form (Hurler syndrome). Ethics precludes randomized comparison of ERT with HCT, but insight into this comparison is presented with an international cohort of patients with Hurler syndrome who received long-term ERT from a young age. MethodsLong-term survival and neurologic outcomes were compared among three groups of patients with Hurler syndrome: 18 treated with ERT monotherapy (ERT group), 54 who underwent HCT (HCT group), and 23 who received no therapy (Untreated). All were followed starting before age 5 years. A sensitivity analysis restricted age of treatment below 3 years. ResultsSurvival was worse when comparing ERT versus HCT, and Untreated versus ERT. The cumulative incidences of hydrocephalus and cervical spinal cord compression were greater in ERT versus HCT. Findings persisted in the sensitivity analysis. ConclusionAs newborn screening widens treatment opportunity for Hurler syndrome, this examination of early treatment quantifies some ERT benefit, supports presumptions about BBB impenetrability, and aligns with current guidelines to treat with HCT.

A “home made” titanium telescopic mesh for an emergent multilevel cervical corpectomy: A case example of surgical preparedness

Abstract We present the case of a 49 years old man operated as emergency for cervical spinal cord compression for a Pott disease. We had planned a limited anterior cervical decompression with plating and a second stage posterior decompression and stabilization, a few days after the first operation in case of residual compression. Unfortunately, because of the extensive and consistency of dural compression we ended up in removing 4 vertebral bodies. We did not have, in house, a such long cage and plate for the reconstruction. We managed to achieve a good fixation making a “home made” titanium telescopic mesh as well as building a long plate too. The patient did extremely well with a prompt resolution of the neurological deficits. We describe how we manage to solve this problem stressing, in the same time, the importance of a careful plan, when possible, for such difficult cases.

Kinetic change of spinal cord compression on flexion-extension magnetic resonance imaging in cervical spine

ObjectiveWe aimed to determine the changes in cervical canal diameters and spinal cord compression at each level from C2-3 to C7-T1 in flexion and extension positions and to study the use of flexion-extension magnetic resonance imaging (MRI). We also aimed to assess the changes in the length of the spinal cord in flexion and extension positions of the cervical spine. Patients and methodsFlexion-extension MRI scans were performed consecutively on sixty-six patients with neck pain with/without neurogenic symptoms of the cervical spine. All patients were treated conservatively. We investigated the length of the cervical spinal cord (LSC), length of the cervical spinal anterior column (LAC), length of the cervical spinal posterior column (LPC), spinal canal diameter, and severity of cord compression in flexion, neutral, and extension positions. ResultsAt each intervertebral level (from C2-3 to C7-T1), the average spinal canal diameter showed significant decrease from flexion to extension positions (P < 0.05). The average LSC, LAC, and LPC were decreased on extension of the neck compared with flexion (P < 0.05). Higher stages were found in extension position than in flexion position with statistically significant differences (P < 0.05). ConclusionThe use of flexion-extension MRI may demonstrate true pathology that contributes in the pathogenesis of cervical degenerative disease (CDD). Higher stages in spinal cord compression were found in extension position than in flexion position. However, higher stages in spinal cord compression in extension position did not necessarily cause severe myelopathy. This finding is an important evidence for conservative therapy on patient neck position education.

Clinical study of anterior controllable antedisplacement and fusion for the treatment of cervical ossification of posterior longitudinal ligament

Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Methods The data of 45 cases with cervical posterior longitudinal ligament ossification treated by ACAF from March 2017 to October 2017 were retrospectively analyzed, including 25 males and 20 females, age 45-68 years, average 57.5 years. There were 18 cases involving C3 vertebral body, 30 cases involving C4 vertebral body, 40 cases involving C5 vertebral body, 34 cases involving C6 vertebral body, and 7 cases involving C7 vertebral body. The function of the neural function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system at preoperation and latest follow-up. The curvature of the cervical spine was measured on the lateral X-ray film of the cervical spine, the maximum occupying ratio of the spinal canal was measured on the cross section of the CT scan, and compression of the cervical spinal cord was evaluated by the cervical MRI. Results Patients were followed up for 3 to 6 months (average, 3.9 months). The improvement of neurological function was obtained in all the patients. The JOA score improvement rate at the latest follow-up was 71.3%±9.6%. The cervical lordosis was improved from preoperative 4.5°±3.8° to 10.3°±4.8° at the latest follow-up. The canal stenosis ratio was decreased from preoperative 54.3%±8.2% to 12.5%±5.3% at the latest follow-up. MRI showed that the cervical spinal cord was adequately decompressed in situ. No specific complications were identified that were associated with this technique. Conclusion The present study elaborates the surgical tips and demonstrates the satisfactory outcome of ACAF for the treatment of OPLL. This novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL. Key words: Cervical vertebrae; Ossification of posterior longitudinal ligament; Treatment outcome

Symptomatic cord compression by paraspinal musculature following cervical laminectomy: rare complication.

Cervical laminectomy is an effective treatment for multilevel cervical compressive myelopathy. Symptomatic spinal cord compression (SSCC) by paraspinal musculature (PSM) following cervical laminectomy is rarely reported. The aim of this study was to evaluate the frequency and pathogenesis of this complication after cervical laminectomy. Between 2007 and 2016, the medical records of 1309 cervical laminectomy patients were reviewed. From these 1309 records, seven patients (five men and two women; average age, 64.12years; range 48-78years) with SSCC by PSM following cervical laminectomy were identified. The incidence and possible risk factors of this rare condition were evaluated. The frequency of SSCC by PSM following cervical laminectomy was 0.53%. Presenting symptoms included paralyses and paresthesias, depending on the level and severity of cervical spinal cord compression. The initial onset of neurologic deterioration varied from 12h to 21days after operation. Most patients recovered well after surgical management with an average Barthel index of 74.3 at 6months after surgery. In comparison with 63 controls, this rare complication was associated with preoperative cervical kyphosis, prior antiplatelet therapy, and posterior decompression with prone position. SSCC by PSM is a rare but devastating complication following cervical laminectomy, especially in those patients with preoperative kyphosis, prior antiplatelet treatment, and decompression with prone position. MRI is an ideal tool to identify this complication. Rapid cervical cord decompression and avoidance of recurrent compressive events can achieve a good clinical outcome. These slides can be retrieved under Electronic Supplementary Material.

A Case of Rheumatoid Cerebral Vasculitis Presenting to the ED

Central nervous system involvement in rheumatoid arthritis is infrequent. The most frequent neurological manifestations of rheumatoid arthritis are peripheral neuropathy and cervical spinal cord compression due to subluxation of the cervical vertebrae. Cerebral rheumatoid vasculitis is an uncommon and serious complication which can be life-threatening Neurological involvement in RA is rare, present in only 1% of patients. Disorders of the central nervous system (CNS) include cervical myelopathy, vasculitis, RNs located within the CNS, or meningitis. Stroke also occurs with increased frequency. CNS vasculitis is extremely rare. The diagnosis is supported by magnetic resonance imaging (MRI), alone or with magnetic resonance angiography (MRA), showing the segmental vascular stenosis characteristic of vasculitis. Peripheral neuropathy is usually manifested as sensorimotor neuropathy or mononeuritis multiplex. The underlying mechanism is small vessel vasculitis of the vasa vasorum of the nerves with ischaemic neuropathy and demyelinisation as part of the rheumatoid vasculitis (RV) syndrome. Rheumatoid vasculitis typically affects small and medium-size blood vessels. It is associated with high rates of premature mortality with up to 40% of patients dying by 5 years as well as significant morbidity due to both organ damage from vasculitis and consequences of the treatment. High levels of circulating immune complexes have been observed in atients with rheumatoid vasculitis, and in particular high serum levels of rheumatoid factor are often detected at the time of onset of vasculitis.Deposition of immune complexes most likely contributes to small vessel inflammation and organ damage. Anti CCP levels also tend to be higher in patients with RA who have systemic vasculitis than in those who do not. Histologically, rheumatoid vasculitis involves blood vessels of the small arteries, and all layers of the vessel wall are infiltrated by neutrophils, lymphocytes, and plasma cells.

Should Asymptomatic Patients With Cervical Spinal Cord Compression and Spinal Cord Signal Change Undergo Surgical Intervention?

Should Asymptomatic Patients With Cervical Spinal Cord Compression and Spinal Cord Signal Change Undergo Surgical Intervention?

Patient’S Health Problems After Injury-Related Damage of Cervical Spine

Abstract In the following review there is described the case of 36-year-old patient with trauma-related fracture of cervical spine followed by tetraparesis resulting from compression and ischaemia foci of cervical spinal cord. On the basis of medical record’s analysis as well as on observation made by authors, the model of nursing process adjusted to patient’s needs is described in this article. In the course of hospitalization the typical complications were observed: respiratory tract infections, bedsores, water-electrolyte imbalances, arrhythmias, emotional disturbances resulting not only from injury but also, with high probability, as aftermath of post-traumatic stress. Material and methods. This paper discusses the case of a patient who was hospitalized at the University Orthopedic and Rehabilitation Hospital due to cervical spine and spinal cord injury. Method - a case study. Medical documentation was analyzed, including Intensive Care Unit (ICU) information cards and doctor and nurse reports. The purpose of this work was to assess the impact of cervical spine injury on nursing problems with a patient admitted to ICU under life-threatening conditions. Summary. This paper discusses the case of a 36-year-old patient with a broken cervical spine and a tetraplegia resulting from pressure and foci of ischemia in the cervical spine region. This article presents a nursing model, accounting for the problems specific to this patient, that is based on the analysis of medical documentation and observation. During hospitalization typical complications were observed - infections of the respiratory system, bedsores, electrolyte disruption, disruption of the electrical activity of the heart, emotional disturbance resulting from the injury, but also likely being post-traumatic stress disorder (PTSD) in nature.