Case report: A complete lower cervical fracture dislocation without permanent neurological impairment

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Trauma Care

Background:

• Complete lower cervical spine fractures and dislocations typically cause severe spinal cord injury.
• A subset of patients present with minimal or no neurological deficits, termed "lucky fracture dislocation."
• Diagnosis and management of these injuries are challenging due to subtle presentations.

Observation:

• A 73-year-old male experienced neck and body aches post-trauma with preserved limb sensation and movement.
• Initial cervical radiographs appeared normal; however, CT and MRI confirmed a complete C7 fracture and dislocation.
• Preoperative halo traction failed to achieve reduction.

Findings:

• Surgical fracture reduction and internal fixation were successfully performed.
• Postoperatively, the patient experienced significant pain relief, maintaining pre-existing limb sensory and motor function.
• Two years later, sensory recovery in the left ulnar forearm and improved right upper extremity flexion strength were noted.

Implications:

• Emphasizes thorough clinical evaluation for cervical spine injuries in trauma patients, regardless of neurological status.
• Highlights the critical need to avoid improper patient positioning during handling and surgery to prevent neurological deterioration.
• Suggests surgical intervention can be effective for managing "lucky fracture dislocation" of the cervical spine.