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Disc herniation in cervical fracture subluxation
J F Harrington1, M J Likavec, A S Smith
1Case-Western Reserve University School of Medicine, Cleveland, Ohio.
Neurosurgery
|September 1, 1991
Summary
Traumatic midcervical fracture subluxations are linked to higher rates of herniated discs, particularly in flexion injuries. Early discectomy may improve outcomes for patients with partial spinal cord injury.
Area of Science:
- Neurosurgery
- Radiology
- Spinal Cord Injury Research
Background:
- Previous studies reported low rates (<5%) of disc herniation in cervical spinal cord injuries using computed tomographic scans with contrast myelography.
- This study hypothesized that severe injuries involving bone or ligamentous damage near the disc space would correlate with increased disc herniation rates.
Observation:
- Thirty-seven patients with traumatic midcervical fracture subluxations were reviewed.
- Injuries were classified based on plain films, tomograms, and computed tomographic scans.
- Twenty-five computed tomographic scans with contrast myelography and one MRI were analyzed for herniated discs.
Findings:
- Disc herniation was identified in 35% of patients at the injury level.
- Herniated discs were observed in 47% of patients with partial neurological deficits.
- Herniated discs were most common in flexion dislocation and flexion compression injuries.
Implications:
- Severe midcervical injuries may have a higher incidence of associated disc herniation than previously reported.
- Discectomy in patients with partial spinal cord injury and herniated discs showed improved outcomes.
- These findings may influence diagnostic and treatment strategies for traumatic cervical spinal cord injuries.