Successful surgery of cervical bone fracture in a patient with anterior screw fixation: A Case Study
Dr. Manish Kumar MBBS, DNB (Neurosurgery)
Surgical Case Reports 2017 © The Park Group of Hospitals. 2017
Cervical bone fracture is a medical situation when a bone in the neck region of spine breaks out, whereas, a cervical dislocation is the ligament injury in neck causing an abnormal separation in the adjoining bones of the spine. Although, cervical fractures of the spine are common, yet, the cases of C1 and C2 vertebrae fracture are severe cases requiring more attention and immediate surgery. An electrician, who fell from the electric pole while at work, was brought with C1 fracture in the vertebrae. With difficulty in neck and head movement, the patient also had weak limbs. We divided the treatment in two parts wherein the first part was the Skull Pin Traction and the later the anterior screw fixation surgery was carried out. The patient was discharged after a week of intensive observation and once we saw recovery signs in him with the ability to move his head and neck smoothly.
Cervical bone fracture of is a common yet critical situation as the same requires intensive care and takes at least 6 – 8 weeks to heel. However, the C1 and C2 fractures are not so common. There are more noticeable cases of C4 and C5 injuries. The usual cause of C1 fracture is fall impacting the head or diving. Any incident which lays stress on the head and neck of a person may cause C1 and C2 fractures. These two fractures are highly risk oriented as the location of the affected vertebrae might cause complete paralysis to the individual. There can be a situation where in the fracture has damaged the vertebral arteries and interfere with the neurology system by restricting the blood flow to the brain.
A 39 year old electrician showed the broken C1 and C2 vertebrae in CT scan when admitted to the Park Hospital, Gurugram. The MRI observed complete damage of C1 and C2 bones of the cervical spine. He was brought in after he had a fall from an electric pole and suffered difficulty in neck and head movement. The emergency and trauma team helped him with the first aid and basic treatment. The treatment was started by the team of neurologists led by Dr. Manish Kumar. The team performed Skull Pin Traction initially to support the head movement and later Anterior Screw Fixation surgery was performed to enable the complete neck movement of the patient. The patient was discharged after a week of observation and the confirmation of him facing no difficulty in the head or spinal movement.
According to Dr. Manish, this surgery was very complicated as there was neck bone fracture, which is also known as cervical spine (neck) trauma. The injury is like decapitation. About 25-40% of these fractures are fatal at the time of accident due to cessation of breathing and sudden loss of other vital functions or other associated injuries like Brain injuries. Many patients suffer with severe morbidity because of poor handling during transit or in the hospital sometimes even resulting in prolonged hospital stay and death.
Post surgery, the patient is very well and is also not having any issues with the limbs movement and is also not experiencing any limb weakness. He is eating well and is able to talk properly now as mentioned by the patient himself. He further added to the statement that he was able to walk the next day of the surgery and hopefully will soon have normal range of neck movement.
The case study is presented with the consent of the patient and his family members.