Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review
Key Clinical Message This case report describes our experience of surgical strategies of two patients with neglected subaxial cervical spine fracture‐dislocation that came to our center with subsequent follow‐ups. Subaxial cervical spine fracture‐dislocation must be immediately diagnosed and treated...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
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| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.8421 |
| _version_ | 1827365517413842944 |
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| author | Ahmad Pour‐Rashidi Bhavya Pahwa Mohammad Hossein Khanmirzaie Mahshid Fallahpour Hamed Hanif Mohammad Shirani |
| author_facet | Ahmad Pour‐Rashidi Bhavya Pahwa Mohammad Hossein Khanmirzaie Mahshid Fallahpour Hamed Hanif Mohammad Shirani |
| author_sort | Ahmad Pour‐Rashidi |
| collection | DOAJ |
| description | Key Clinical Message This case report describes our experience of surgical strategies of two patients with neglected subaxial cervical spine fracture‐dislocation that came to our center with subsequent follow‐ups. Subaxial cervical spine fracture‐dislocation must be immediately diagnosed and treated. However, it can be neglected in some cases, especially in developing health care systems and patients with low socioeconomic status. We reported two neglected subaxial cervical fracture‐dislocation with a mean age of 54 years old who presented with axial cervical pain, and decreased muscle forces. In one out of two, cervical closed traction was applied, then unsuccessful result led to circumferential decompression and fixation via anterior–posterior (AP) approach. Accordingly, we used AP approach without applying closed reduction in another patient successfully. Except one of our cases who died after 2 weeks of surgery due to aspiration pneumonia, other one found complete improvement at the end of 6‐month follow‐up. Our study emphasizes the importance of AP approach in patients with irreducible joint dislocations. The approach can minimize the surgical risks and increase the cost–benefit as compared to three or more staged approaches. Our approach is less intensive than some other AP approaches while is a safe and efficacious procedure since the posterior reduction is not performed before discectomy and decompression. |
| first_indexed | 2024-03-08T08:29:38Z |
| format | Article |
| id | doaj.art-949eab8fe4fa491fb0a240289f670487 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-08T08:29:38Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-949eab8fe4fa491fb0a240289f6704872024-02-02T03:36:32ZengWileyClinical Case Reports2050-09042024-01-01121n/an/a10.1002/ccr3.8421Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature reviewAhmad Pour‐Rashidi0Bhavya Pahwa1Mohammad Hossein Khanmirzaie2Mahshid Fallahpour3Hamed Hanif4Mohammad Shirani5Department of Neurosurgery, Sina Hospital Tehran University of Medical Sciences Tehran IranUniversity College of Medical Sciences and GTB Hospital Delhi IndiaDepartment of Neurosurgery Tehran University of Medical Sciences Tehran IranDepartment of Public Health San Diego State University (SDSU)‐University of California San Diego (UCSD) San Diego California USADepartment of Neurosurgery, Sina Hospital Tehran University of Medical Sciences Tehran IranDepartment of Neurosurgery, Sina Hospital Tehran University of Medical Sciences Tehran IranKey Clinical Message This case report describes our experience of surgical strategies of two patients with neglected subaxial cervical spine fracture‐dislocation that came to our center with subsequent follow‐ups. Subaxial cervical spine fracture‐dislocation must be immediately diagnosed and treated. However, it can be neglected in some cases, especially in developing health care systems and patients with low socioeconomic status. We reported two neglected subaxial cervical fracture‐dislocation with a mean age of 54 years old who presented with axial cervical pain, and decreased muscle forces. In one out of two, cervical closed traction was applied, then unsuccessful result led to circumferential decompression and fixation via anterior–posterior (AP) approach. Accordingly, we used AP approach without applying closed reduction in another patient successfully. Except one of our cases who died after 2 weeks of surgery due to aspiration pneumonia, other one found complete improvement at the end of 6‐month follow‐up. Our study emphasizes the importance of AP approach in patients with irreducible joint dislocations. The approach can minimize the surgical risks and increase the cost–benefit as compared to three or more staged approaches. Our approach is less intensive than some other AP approaches while is a safe and efficacious procedure since the posterior reduction is not performed before discectomy and decompression.https://doi.org/10.1002/ccr3.8421case reportcervicaldislocationneglectedsurgery |
| spellingShingle | Ahmad Pour‐Rashidi Bhavya Pahwa Mohammad Hossein Khanmirzaie Mahshid Fallahpour Hamed Hanif Mohammad Shirani Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review Clinical Case Reports case report cervical dislocation neglected surgery |
| title | Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review |
| title_full | Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review |
| title_fullStr | Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review |
| title_full_unstemmed | Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review |
| title_short | Risk factors and surgical approaches in neglected subaxial cervical spine fractures‐dislocations: Experiences with two cases and literature review |
| title_sort | risk factors and surgical approaches in neglected subaxial cervical spine fractures dislocations experiences with two cases and literature review |
| topic | case report cervical dislocation neglected surgery |
| url | https://doi.org/10.1002/ccr3.8421 |
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