Cervical facet dislocation adjacent to the fused motion segment
This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, h...
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doaj-b3e72e6c1d064f28a1575f013b3164152021-04-02T11:29:18ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neurosciences in Rural Practice0976-31470976-31552016-01-0170113313610.4103/0976-3147.172150Cervical facet dislocation adjacent to the fused motion segmentKunio Yokoyama0Masahiro Kawanishi1Makoto Yamada2Hidekazu Tanaka3Yutaka Ito4Toshihiko Kuroiwa5Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto, Osaka, JapanDepartment of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto, Osaka, JapanDepartment of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto, Osaka, JapanDepartment of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto, Osaka, JapanDepartment of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto, Osaka, JapanDepartment of Neurosurgery Osaka Medical College, Takatsuki, Osaka, JapanThis study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.http://www.thieme-connect.de/DOI/DOI?10.4103/0976-3147.172150adjacent segment diseaseanterior cervical fusioncervical facet dislocationspinal cord injury |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kunio Yokoyama Masahiro Kawanishi Makoto Yamada Hidekazu Tanaka Yutaka Ito Toshihiko Kuroiwa |
spellingShingle |
Kunio Yokoyama Masahiro Kawanishi Makoto Yamada Hidekazu Tanaka Yutaka Ito Toshihiko Kuroiwa Cervical facet dislocation adjacent to the fused motion segment Journal of Neurosciences in Rural Practice adjacent segment disease anterior cervical fusion cervical facet dislocation spinal cord injury |
author_facet |
Kunio Yokoyama Masahiro Kawanishi Makoto Yamada Hidekazu Tanaka Yutaka Ito Toshihiko Kuroiwa |
author_sort |
Kunio Yokoyama |
title |
Cervical facet dislocation adjacent to the fused motion segment |
title_short |
Cervical facet dislocation adjacent to the fused motion segment |
title_full |
Cervical facet dislocation adjacent to the fused motion segment |
title_fullStr |
Cervical facet dislocation adjacent to the fused motion segment |
title_full_unstemmed |
Cervical facet dislocation adjacent to the fused motion segment |
title_sort |
cervical facet dislocation adjacent to the fused motion segment |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Journal of Neurosciences in Rural Practice |
issn |
0976-3147 0976-3155 |
publishDate |
2016-01-01 |
description |
This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation. |
topic |
adjacent segment disease anterior cervical fusion cervical facet dislocation spinal cord injury |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/0976-3147.172150 |
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