A Case Report of an Unstable C-spine Fracture in the Emergency Department

Unstable cervical spine (c-spine) fractures are of high concern in traumatic incidents because they may result in significant morbidity and mortality. This is a case of a 44-year-old male who presents to the Emergency Department (ED) with neck pain after recreational wrestling and was found to have an unstable C-spine fracture. His treatment course was complicated by multiple interrupted hospital stays due to leaving against medical advice (AMA) and subsequent returns to the emergency department. The patient received both CT and MRI imaging and ultimately underwent occiput to C3 fusion with drain placement with a favorable outcome. This case report highlights the diagnosis and treatment of a patient with an unstable c-spine fracture. Key lessons from the case include the importance of timely recognition of patients with a potential c-spine fracture and identifying those who are at risk for nonadherence to medical treatment plans in order to provide interventions and improve chances of adherence. For patients in which pre-hospital care is involved, such as emergency medical services (EMS), recognition and appropriate care, such as c-spine stabilization, may be important for long-term outcomes.

Unstable c-spine fracture, polysubstance use, spinal injury, neck trauma.