Acute cervical cord injury without fracture or dislocation of the spinal column

Koyanagi, Izumi; Iwasaki, Yoshinobu; Hida, Kazutoshi; Akino, Minoru; Imamura, Hiroyuki; Abe, Hiroshi

doi:10.3171/spi.2000.93.1.0015

Cited by 86 publications

(82 citation statements)

References 44 publications

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“…SCI-WORA is most likely to occur in blunt cervical trauma of children beyond the age of 8 years because of the high elasticity of the paediatric spine, resulting from unique anatomic and biomechanical properties. 6,12,13,18,19 In adults, cervical spinal cord injury usually is associated with bony malalignment, locking of facets, disruption of the vertebral body or fracture of elements of the neural arch. Since the introduction of MRI, a post-traumatic abnormality can frequently be depicted in the spine of SCIWORA patients.…”

Section: Discussionmentioning

confidence: 99%

“…13 Spinal cord injury without radiographic evidence of trauma, the so-called SCIWORET syndrome, 20 is associated with the radiological delineation of spondylotic changes such as bony spurs, cervical canal stenosis, protruded discs and ossification of posterior longitudinal ligament (OPLL). 6,19 These degenerative changes could allow for damage to the neural structures by excessive traction or pinching during the accident. 6,13,19,21,22 SCIWORET patients frequently present with central cord syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…6,19 These degenerative changes could allow for damage to the neural structures by excessive traction or pinching during the accident. 6,13,19,21,22 SCIWORET patients frequently present with central cord syndrome. 13,19,23 Therefore, an eventual neurological dysfunction is most likely to affect the upper extremities and especially the hands.…”

Section: Discussionmentioning

confidence: 99%

“…19 In the adult, SCIWORET is encountered more frequently than SCIWORA syndrome, even though both conditions are rare. 9,10,12,19 In recent years, the radiological assessment protocol for acute cervical spine trauma was challenged: increasingly the three standard radiological views are combined with MRI or helical CT of the complete cervical spine instead of conventional CT. [5][6][7] Especially in patients with neurological dysfunction, MRI probably is the first radiological modality to be applied. 4,5 Multiplane MRI not only depicts eventual neurocompression and discoligamentous injury, it may also show haematomyelia, cord transection and cord oedema.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] However, in recent years this evaluation protocol was challenged by the introduction of magnetic resonance imaging (MRI) and helical CT of the complete cervical spine. 4 The latter diagnostic methods are increasingly used in the acute stage and especially in case of neurological dysfunction at first presentation or in case of negative results of initial plain films and conventional CT. [5][6][7] Moreover, plain films and CT, on which spinal cord injury without radiological abnormality (SCIWORA) diagnosis usually is based, may be insufficient and additionally miss soft-tissue lesions. 3,8,9 MRI depicts several types of intrinsic cord lesions as well as neurocompressive and discoligamentous injuries.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Wenger

Pj²,

Alarcón³

et al. 2003

Spinal Cord

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Study design: A case report of blunt cervical spine trauma associated with cord oedema at the C3/C4 level with temporary Frankel/American Spinal Injury Association Grade A quadriparesis and motion segment instability without evidence of associated bony lesions (spinal cord injury without radiological abnormality, SCIWORA lesion). Objectives: By means of a rare and illustrative case, the reader's attention is focused on eventual marked cervical motion segment instability in SCIWORA patients. Setting: A department of Neurology in Quito, Ecuador and a department of Neurosurgery in Bern, Switzerland. Method: A 73-year-old man sustained blunt cervical spine trauma. After resolution of paraparesis, dynamic studies of the cervical spine revealed translational instability of C3 over C4. The patient underwent segment fusion by intervertebral cage insertion and plate fixation. Results: The patient had recovered almost completely from tetraparesis under conservative treatment. The postoperative course was uneventful. Solid bony fusion of the C3/C4 motion segment was obtained. Conclusion: Despite normal cervical alignment, the lack of bony lesions and neurological recovery, magnetic resonance imaging and dynamic studies may reveal marked translational cervical motion segment instability requiring segment fusion in order to prevent ongoing damage of the spinal cord.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Wenger

Pj²,

Alarcón³

et al. 2003

Spinal Cord

View full text Add to dashboard Cite

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Cervical spinal cord injuries associated with resuscitation from fatal circulatory collapse

Miyata

Mikami

Koyanagi

et al. 2015

Acute Medicine & Surgery

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Introduction: Fatal cervical spinal cord injury (SCI) associated with collapse of the circulatory and/or respiratory system usually consists of high cervical SCI caused by high-energy trauma. As the elderly population grows, however, the etiology of fatal SCI may be changing. The aim of the present study was to understand the current clinical features of fatal SCI. Methods:Retrospective analysis was performed on 73 consecutive patients with acute cervical SCI between 2007 and 2013. Fourteen (19%) of them presented in a state of coma due to severe circulatory collapse after cardiac arrest (CA, n = 11) or respiratory arrest (RA, n = 3), and were resuscitated at the scene or hospital. The clinical features and radiological findings of these 14 patients were compared with those of the other 59.Results: Eleven of the 14 fatal SCI patients were injured by minor traumas. Computed tomography revealed C1-2 fractures or dislocations in 11 patients and subaxial injuries in three patients. Eleven patients showed some kind of ossification of the spinal column ligaments. In a univariate analysis, the predictive factors associated with fatal circulatory collapse were age (P = 0.02), estimated C1/2 injury (P < 0.0001), and complete tetraplegia (P < 0.0001). In a multiple regression model for fatality, the odds ratios (OR) for C1/2 injury and ASIA impairment score (AIS) A were 20.58 (P = 0.006) and 151.97 (P = 0.002). Conclusions:A state of unconsciousness with fatal circulatory collapse was significantly associated with C1/2 injury and AIS A.Moreover, our data show that fatal SCI can occur due to minor trauma in elderly people.

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Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

Kikuta

Ishihara

Yagata

et al. 2021

Acute Medicine & Surgery

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Background We report the first case of retro‐odontoid pseudotumor with an isolated symptom of C2–C3 dysesthesia triggered by a traumatic event. Case Presentation An 86‐year‐old man, who was a wood craftsman for more than 50 years, presented to the emergency room with sudden‐onset severe posterior head and neck dysesthesia after accidentally falling backward. No neurological impairment of the extremities was noted. Computed tomography revealed a C2–C7 osteophyte formation, mainly in front of the vertebral bodies. Moreover, magnetic resonance imaging showed cervical spinal cord compression by a soft tissue mass posterior to the odontoid process of the axis. Therefore, we diagnosed a cervical spine injury with an isolated symptom of C2–C3 dysesthesia due to a retro‐odontoid pseudotumor. He did not undergo surgical intervention and was transferred to a rehabilitation hospital on day 11 for pain control. Conclusion Our report could be useful to emergency physicians dealing with similar cases of cervical symptoms following trauma.

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Acute cervical cord injury without fracture or dislocation of the spinal column

Cited by 86 publications

References 44 publications

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Cervical spinal cord injuries associated with resuscitation from fatal circulatory collapse

Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

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