TY  - BOOK
AU  - Dowlati, Ehsan
AU  - McGowan, Jason E
TI  - C2-C3 spinal fracture subluxation with ligamentous and vascular injury: a case report and review of management. [Review]
SN  - 2058-6124
PY  - 2019///
KW  - *Axis, Cervical Vertebra/in [Injuries]
KW  - *Fracture Dislocation/su [Surgery]
KW  - *Longitudinal Ligaments/in [Injuries]
KW  - *Multiple Trauma/su [Surgery]
KW  - *Radiculopathy/su [Surgery]
KW  - *Spinal Cord Compression/su [Surgery]
KW  - *Spinal Fractures/su [Surgery]
KW  - *Vertebral Artery Dissection/dt [Drug Therapy]
KW  - Adult
KW  - Axis, Cervical Vertebra/su [Surgery]
KW  - Brain Infarction/dg [Diagnostic Imaging]
KW  - Cervical Vertebrae/in [Injuries]
KW  - Cervical Vertebrae/su [Surgery]
KW  - Computed Tomography Angiography
KW  - Diskectomy
KW  - Fracture Dislocation/co [Complications]
KW  - Fracture Dislocation/dg [Diagnostic Imaging]
KW  - Humans
KW  - Male
KW  - Nerve Transfer
KW  - Platelet Aggregation Inhibitors/tu [Therapeutic Use]
KW  - Radiculopathy/co [Complications]
KW  - Spinal Cord Compression/et [Etiology]
KW  - Spinal Fractures/co [Complications]
KW  - Spinal Fractures/dg [Diagnostic Imaging]
KW  - Spinal Fusion
KW  - Vertebral Artery Dissection/co [Complications]
KW  - Vertebral Artery Dissection/dg [Diagnostic Imaging]
KW  - Vertebral Artery/in [Injuries]
KW  - MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Journal Article
N2  - Case presentation: We present the case of a 29-year-old polytrauma patient with an unstable C2-C3 fracture subluxation secondary to hyperextension and rotation injury with complete ligamentous dissociation and vertebral artery dissection after a high-velocity injury. We review the literature on injury patterns, associated complications and neurological outcomes in subaxial cervical spine injuries; Discussion: Our patient's injuries had several components including fracture subluxation, ligamentous disruption, central cord syndrome, and vascular insult. The lack of a unifying algorithm to guide treatment decisions highlights the variations in pathology and subsequent limitations in generalizability of current literature. Our patient underwent an open anterior C2-C3 reduction and discectomy with fusion and plating and a subsequent C2-C4 posterior instrumented fusion. The patient regained some motor function postoperatively and through rehabilitation. Careful consideration of multiple components is crucial when treating subaxial spine injuries; Introduction: Spinal cord injury is one of the leading causes of paralysis and permanent morbidity. High cervical spine injuries, in particular, have the potential to be fatal and debilitating due to injury to multiple components, including but not limited to, discoligamentous disruption, vascular insult and spinal cord injury. To date, no unifying algorithm exists making it challenging to guide treatment decisions
UR  - https://dx.doi.org/10.1038/s41394-019-0150-7
ER  -