J Korean Soc Spine Surg.  2010 Mar;17(1):26-32. 10.4184/jkss.2010.17.1.26.

Multiple Noncontiguous Fractures in Cervical Spine: Cases Report

• Kim MS
• Lee CB
• Ha JH
• Park HT
• Choi SJ
• Park JH

• KMID: 2003096
• DOI: http://doi.org/10.4184/jkss.2010.17.1.26

Abstract

STUDY DESIGN: Cases report
OBJECTIVES
We report 2 cases of relatively rare cervical fracture. SUMMARY OF LITERATURE REVIEW: Although numerous studies in the literature have investigated cervical spine injuries, patients with multiple-level cervical fractures have not been commonly described. Multiple non-contiguous cervical fractures are distinctively unusual.
MATERIALS AND METHODS
First case was a girl aged 8 years and 4 months who had multifocal compression fracture of C3, 5, 6 & T7, 8 without spinal cord injury. Second case was a thirty nine-year-old female who had Type I Hangman's fracture and compression fractures of C3, 7.
RESULTS
We had satisfactory results of them treated nonsurgically.
CONCLUSIONS
We should remind that cervical spinal column can incur multiple injuries in variant patterns.

Keyword

Cervical spine; Multiple noncontiguous fractures

MeSH Terms

Female
Fractures, Compression
Humans
Multiple Trauma
Spinal Cord Injuries
Spine*

Figure

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  Fig. 1. Plain radiograph and CT scan show wedging compression of C6 without retro-pulsion of bony fragment and mild kyphotic angulation of cervical curve. Spinal canal is relatively preserved.

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  Fig. 2. MRI scan shows marked compression and anterior wedging of C6 spine with minimal spinal canal narrowing. Multifocal high signal intensity on T2WI and STIP image with contrast enhancement are seen in other spines (C3, C5, T7 and T8) suggesting multifocal acute compression fracture. Significant abnormal spinal cord signal is not seen.

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  Fig. 3. 9 months after injury: Mild kyphotic angulation of cervical curve is remained.

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  Fig. 4. Plain radiograph and CT scan show bilateral symmetrical fractures detaching the pedicles from the body of C2 (Hangman's fracture) and linear fracture lines in the anterior body of the C7

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  Fig. 5. MRI scan shows the loss of height of the C3 and C7 body, with hyposignal on T1WI, and hypersignal on T2WI. The compressive myelopathy is not seen in the cervical spinal cord.

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  Fig. 6. After halovest immobilization, plain radiograph shows well reduction state of C2 and lordotic curve.

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  Fig. 7. 12 weeks after injury: Dynamic view of cervical column showed acceptable stabilization and union of Hangman's fracture.

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