Unusual Evolution of Bone Graft in Misdiagnosed C7 Fracture: Case Report
D.A., a 46 year old male, was involved in a motor vehicle accident in October, 1986, during which he reported a hyperflexion injury of the cervical spine. The patient immediately began complaining of persistent neck pain, and after several weeks left arm pain and paraesthesia of the 4th and 5th fingers of the left hand appeared, and he consulted a doctor. The first x-rays taken in January 1987 were considered negative, although in retrospect, an initial alteration of the body of C7 was quite evident (Fig. 1). Because of persistent pain, a second set was taken in February 87, which showed a crushed and deformed vertebral body at C7 (Fig. 2). A minerva cast was applied for 4 months, but despite this a definite lower limb spastic paralysis appeared. CT scan, performed on May 87 showed no extrinsic medullary compression, but the body of C7 looked like an empty bony shell interrupted anteriorly and posteriorly. 4 months had elapsed since the crushed vertebra was diagnosed. The patient was admitted to our Clinic in June 1987. Initial physical examination revealed obvious signs of medullary and radicular compression. Myelography was performed and showed complete interruption of the dye column at the inferior border of CI. That night the neurologic picture suddenly worsened and the patient became quadriplegic. An emergency operation was performed with decompressive somatectomy of C7 by an anterior approach, and arthrodesis of C6-T1 using a tricortical cancellous graft taken from the iliac crest .
KeywordsCervical Spine Vertebral Body Motor Vehicle Accident Progressive Collapse Discal Tissue
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