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Delayed paralysis after cervical fracture-dislocation. Case report

J C White, L W Kneisley, A B Rossier

    Journal of Neurosurgery
    |April 1, 1977
    PubMed
    Summary
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    Spinal cord injury can lead to delayed, ascending damage years later. A cervicothoracic fracture-dislocation resulted in progressive quadriplegia and sensory loss due to a developing syrinx.

    Area of Science:

    • Neurology
    • Spinal Cord Injury Research
    • Neurosurgery

    Background:

    • Spinal cord injuries (SCIs) can present with delayed complications.
    • Cervicothoracic fracture-dislocations are severe traumatic injuries.
    • Initial SCI assessment may not predict long-term sequelae.

    Purpose of the Study:

    • To report a rare case of late-onset ascending spinal cord damage.
    • To investigate the association between initial trauma and delayed neurological deterioration.
    • To highlight the importance of long-term follow-up in SCI patients.

    Main Methods:

    • Case report of a patient with a history of cervicothoracic fracture-dislocation.
    • Clinical evaluation of progressive neurological deficits over 16 years.

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  • Intraoperative verification of a central syrinx 18 years post-injury.

    • Main Results:

    • Initial injury showed only transient mild paresthesia.
    • Progressive quadriplegia developed 16 years post-trauma.
    • Ascending dissociated sensory loss and a central syrinx were confirmed.

    Conclusions:

    • Delayed ascending spinal cord damage is a potential complication of spinal trauma.
    • Syrinx formation can occur years after the initial injury.
    • Long-term monitoring is crucial for managing SCI patients and preventing secondary complications.