Journal of Musculoskeletal Trauma

Atlanto-occipital Assimilation Can be Misdiagnosed as Atlantoaxial Dislocation: A Case Report: Kwang Bok Lee, Sang Rim Kim, Kwang Hoon Jung; J Korean Fract Soc 2005;18(4):470-473. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.470

Abstract PDF: We present a rare case that atlanto-occipital assimilation can be misdiagnosed as C1-2 anterior subluxation. This is a lack of familiarity in orthopedic surgeon that was not used to manage the upper cervical spine injury. So the treatment of this entity need to get careful diagnosis and attention.

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Immediate Quadriparesis after Posterior Sublaminar Wiring for Cervical Fracture Dislocation: A Case Report: Byeong Yeon Seong, Chan Ji Park, Dong Seong Park; J Korean Soc Fract 1999;12(3):679-685. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.679

Abstract PDF: Open reduction and internal fixation of the cervical spine is a commonly performed method of treatment for acute cervical fracture dislocation. A sudden or gradual worsening of the neurological status of a patient during reduction should alert the physician to the presence of high grade compression of the spinal canal. Loss of neurological function during or after manipulation or open reduction and internal fixation should raise the suspicion of compression of the spinal cord from a lesion occupying the canal, such as a herniated disc, buckling of the ligamentum flavum, an epidural hematoma or bone fragments. Magnetic resonance imaging or myelogram are the most helpful diagnostic means and should be used initially if suspected. Treatment is anterior decompression and autogenous strut bone graft. Causes of our case include ruptured disc, vertebral end plate and posterior longitudinal ligament. We experienced a case of immediate quadriparesis after posterior decompression and sublaminar wiring for cervical fracture dislocation which was resulted from ruptured disc, vertebral end plate and posterior longitudinal ligament.

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Cervical Spine Fractures in Ankylosing Spondylitis : A case Report: Jae Yoon Chung, Jung Pil Heo, Hyong Yeon Seo; J Korean Soc Fract 1997;10(1):175-179. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.175

Abstract PDF: The patient with ankylosing spondylitis is easily apt to be fractured in spine regions, even by minor trauma due to severe limitation of spinal motion and progressive osteoporosis. In those patients, accurate reduction and rigid internal or external immobilization and postoperative early mobilization is very important to treat or prevent the spinal cord injury. Untill now halo-vest immobilization or posterior fusion is widely accepted method of treatment and there was no report about anterior plate fixation. Authors fused the patient anterorily with tricortical iliac graft and plate with compression mechanism to get early solid bony union, to increase the immediate rigid stability, to correct the deformity and to mobilize the patient early as possible. We have experienced a 54-year-old male patient with ankylosing spondylitis complicating traumatic fracture of the cervical spine at C6-7 and follow up study of 9 years was possible. The patient was injured by minor pedestrian motor vehicle accident. Pre-injury activity was normal, and neurological status was Frankel grade D just after trauma however, it was aggrevated to Frankel grade C paraplegia during position change before operation. The patient was anesthesized with aid of the tracheostomy. Anterior plate fixation was performed with tricortical iliac suut bone graft and plate. And then early mobilization was encouraged with SOMI brace. Neurological status was improved and there was no peri- and post-operative complications. Systemic complications was not occured also. Re-displacement at fracture site with minimal screw loosening during follow up period was observed however, solid bony union was obtained at post-operative 3 months without further displacement or loosening. We report this case with review of literatures for good clinical result of anterior fusion with plate during long term follow up period of 9 years.

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Clinical Application of Halo-Vest Apparatus in Cervical Spine Lesions: Yung Tae Kim, Yong Jung Kim, Ho Seung Lee; J Korean Soc Fract 1995;8(1):262-268. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.262

Abstract PDF: Halo-vest apparatus has the mechanical advantages that provides immediate cervical stabilization and can afford the diagnostic work-up for the acute cervical spine injuried patients, and does not interfere with MRI test. Furthermore, we can take the reduction of the dislocation by controlling it in any plane. Especially it is effective in conseuative treatment in upper cervical lesion without neurologic deficit or patient with high risk of operation. We put on the Halo-vest apparatus in seventeen patients with cervical spine lesion. There were fifteen cases of fracture-dislocation, one case of pathologic fracture, and one case of tuberculous spondylitis. The lesion site were upper ceuical in ten cases and others were lower cervical lesion. Three cases were undergone surgical intervention and were fixed with Halo-vest apparstus for further stabilization. We could get the external fixation for the unstable cervical lesion after several segment fusion. Initial immobilization were undertaken with Gardner well tong, Halter or Halo treation for 1.6 weeks in average. They were changed to Halo-vest apparatus for further immobilization and concomitant ambulation. Halo-vest apparatus were put on for 10.2 weeks to get solid bony union. After then other conventional brace were worn such as neck collar,S.0.M.I., four-poster or Philadelphia brace. The complications were one case of pin loosening, and three cases of pin tract infection.

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