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This 63–year old male had been tetraplegic
after a traffic accident due to a C5–C6 fracture–dislocation. He was
operated on 1973 with posterior wiring and bone grafting (without
anterior decompression) to facilitate early rehabilitation. Two
weeks later he succumbed to a cardiovascular failure. This sagittal
closeup section shows sclerosis of the endplates at the fracture
level and marked compression of the lateral portion of the spinal
cord. Note the intramedullary hematoma. Spinal cord compression is
caused anteriorly by a broken spondylosis ridge that is hinged in
periosteum and peripheral annulus fibrosus. Posteriorly, the
ruptured ligamentum flavum is curled up under the lamina, further
compressing the cord. Behind the lamina the wound hematoma and a
bone graft are seen. The goal of this operation was to facilitate
early mobilization; corpectomy or hemivertebrectomy should have been
considered in a patient with an incomplete neurological deficit.
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©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Academic
University Hospital
Department of Orthopaedic Surgery
Uppsala, Sweden
Reproduction without permission is prohibited
http://www.akademiska.se/
