Case Studies Series: Cervical Spine Fracture
This patient was the first case I ever did after completing my training. He was a 14-year-old high-school student on the local wrestling team. He was horsing around with a friend and the friend picked him up and dropped him on his head.
He was instantly unable to move his arms or legs.
He was brought in by the paramedics to the emergency room as a complete C4 quadriplegic. Complete means that he had no function (either motor or sensory) below the level of injury and being at the C4 level meant he had no muscle control in his arms or legs. He could only breathe spontaneously and move the muscles of his face and head.
He had suffered a C5 burst fracture with severe cord compression.
In the ER, we placed him in cervical traction to try and reduce the fractured C5 vertebrae that was pushing into his spinal cord. He was then taken to the operating room for surgery to decompress his spinal cord. The obvious hope is that by decompressing his spinal cord, we can decrease a secondary injury to the spinal cord and possibly regain some function. We did not even get an MRI before surgery so that we could expedite his care.
He underwent an anterior (from the front of the neck) approach. We did a C5 corpectomy where we removed the body of the C5 vertebrae that had been fractured and decompressed the spinal cord. Once the bone had been removed, we reconstructed the spine from the fourth cervical vertebrae (C4) to the sixth (C6) with a bone graft and metal plates and screws.
He had a prolonged stay in the pediatric ICU and then in the pediatric rehab unit.
I wish I could end his story by saying he had a miraculous recovery of his motor function. He did not. But he did improve and didn’t require a permanent tracheostomy and was able to breathe on his own.
His life was not defined by this tragedy. He completed high school, college and traveled throughout Europe. He is independent, happy and has a meaningful life. He is an example of the perseverance and strength of character we should all strive to have. We (his doctors and family) are all very proud of him.