Complete dislocation with burst fracture of the lower cervical spine. Case report

A patient with a complete fracture dislocation of the C6 vertebra without any neurological deficit is presented. The absence of neurological changes in an area of the spinal canal which is almost completely filled with the spinal cord is remarkable. The mechanism of injury in this patient is believed to be hyperextension associated with significant axial loading. Hyperextension first ruptured the anterior and the posterior longitudinal ligaments and then injured the pedicles of C6. The associated axial loading resulted in a 'bursting' of the posterior elements, thereby providing room for the spinal cord to move dorsally with the avoidance of a major neurological deficit.