J Korean Orthop Assoc.  2012 Jun;47(3):227-231. 10.4055/jkoa.2012.47.3.227.

Airway Compression as a Result of Extensive Prevertebral Hematoma Following Extension Injury of Lower Cervical Spine without Fracture/Dislocation

• Song KJ
• Lee KB
• Park H

• KMID: 2106653
• DOI: http://doi.org/10.4055/jkoa.2012.47.3.227

Abstract

A 77-year-old man presented with severe dyspnea, neck pain, tingling sensation in both hands, and weakness after an acute prevertebral soft tissue hematoma due to distractive-extension injury. Magnetic resonance images demonstrated an extensive hematoma accumulation, anterior longitudinal ligament and longus colli muscle injuries. We report here a case of dyspnea due to an extensive prevertebral hematoma by soft tissue injury without cervical vertebral fracture and/or dislocation and a review the relevant literature.

Keyword

dyspnea; prevertebral hematoma; distractive-extension injury

MeSH Terms

Aged
Dislocations
Dyspnea
Hand
Hematoma
Humans
Longitudinal Ligaments
Magnetic Resonance Spectroscopy
Muscles
Neck Pain
Sensation
Soft Tissue Injuries
Spine

Figure

• 

  Figure 1 (A) Initial C-spine lateral radiograph shows extensive prevertebral soft tissue shadow (retropharyngeal space at C3: 29.3 mm, retrotracheal space at C6: 53.9 mm) without fracture/dislocation from C1 to thoracic area. The retropharyngeal space lies between the pharynx the pharynx and the cervical spine. (B) Post-trauma 1 week C-spine lateral radiograph shows the decrease of prevertebral soft tissue shadow compare to initial C-spine lateral radiograph. (C) Immediate post-operative C-spine lateral radiograph showed marked decrease of prevertebral soft tissue shadow and anterior cervical discectomy and fusion with plate and cage construct at C5-7.

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  Figure 2 Sagittal (A) and axial (B) computed tomography images show the compression and deviation of trachea (asterix) by extensive prevertebral soft tissue shadow (arrows) and no bony abnormality.

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  Figure 3 Sagittal (A, C) and axial (B, D) T1, T2-weighted magnetic resonance images show the deviation and compression of trachea (asterix) and esophagus (arrow head) by extensive hematoma in the prevertebral space (arrows) from C1 to T4, the tear of anterior longitudinal ligament and longus coli muscle, disc herniation C5-6, C6-7.

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  Figure 4 Operative photo shows the extensive hematoma and longus coli muscle tear (white arrows).

Reference

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