Cervical spine fracture through a cervical disc replacement.

Area of Science:

• Orthopedics
• Neurosurgery
• Trauma Surgery

Background:

• Cervical disc replacement (CDR) is a recognized surgical treatment for degenerative disc disease.
• Long-term data on traumatic complications following CDR is limited.
• Bilateral cervical pedicle fractures adjacent to CDR and anterior instrumentation are previously unreported.

Purpose of the Study:

• To report a rare case of cervical spine trauma in a patient with prior cervical disc replacement and fusion.
• To discuss the management and outcomes of complex cervical spine trauma in the context of previous instrumentation.

Main Methods:

• Case report of a 46-year-old male involved in a road traffic accident.
• Patient had a history of C6C7 CDR and C4-6 anterior cervical decompression and fusion.
• Surgical management involved posterior approach for reduction and fixation of bilateral C7 pedicle fractures and right C6C7 facet joint fracture-subluxation.

Main Results:

• The patient sustained bilateral C7 pedicle fractures and a right C6C7 facet joint fracture-subluxation without neurological deficit.
• Posterior reduction and fixation resulted in satisfactory alignment.
• The patient experienced an uneventful recovery.

Conclusions:

• Significant trauma can cause bilateral cervical pedicle fractures even with adjacent cervical fixation.
• The potential protective role of cervical disc replacement in mitigating trauma severity warrants further investigation.
• This case offers valuable insights into managing complex cervical spine trauma with prior instrumentation.