Management of delayed posttraumatic cervical kyphosis

Area of Science:

• Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Unstable cervical spine fractures require surgical fixation to prevent catastrophic neurologic injury.
• Conservative treatment of these fractures can lead to progressive deformity and neurological deficits.
• Delayed reduction of partially healed cervical spine fracture dislocations is not well-characterized.

Observation:

• Three patients with misdiagnosed unstable cervical spine fractures initially received conservative treatment.
• These patients developed progressive kyphotic deformity, myelopathy, and radiculopathy.
• All patients were subsequently managed with closed reduction via halo traction followed by instrumented fusion.

Findings:

• Neurologic function was regained in all three patients without permanent disability.
• Preoperative closed reduction effectively realigned the cervical spine in cases of delayed posttraumatic kyphosis.
• Instrumented fusion successfully stabilized the cervical spine post-reduction.

Implications:

• Early and accurate diagnosis of cervical spine fractures using CT and MRI is crucial.
• Surgical intervention is essential for unstable cervical spine fractures to prevent severe outcomes.
• Closed reduction with halo traction is an effective method for managing delayed posttraumatic cervical kyphosis, facilitating surgical stabilization.