• Charles H Crawford, Ian Mutchnick, and Leah Y Carreon.
• Department of Orthopaedic Surgery, University of Louisville School of Medicine, 550 South Jackson Street, 1st Floor ACB, Louisville, KY, 40202, USA.
• Eur Spine J. 2016 May 1; 25 Suppl 1: 44-8.

BackgroundCaring for pediatric spine trauma patients places spine surgeons in situations that require unique solutions for complex problems. Recent case reports have highlighted a specific injury pattern to the lower cervical spine in very young children that is frequently associated with complete spinal cord injury.MethodsThis report describes the presentation and treatment of a C6-C7 dislocation in a 3-year-old patient with an incomplete spinal cord injury. The highly unstable cervical injury and the need to prevent neurologic decline added complexity to the case.ResultsA multi-surgeon team allowed for ample manpower to position the patient; with individuals with the requisite training and experience to safely move a patient with a highly unstable cervical spine. Initial closed reduction under close neurophysiologic monitoring, posterior fusion and immediate anterior stabilization lead to a successful patient outcome with preserved neurologic function. A traumatic cerebrospinal fluid leak, while a concern early on during the procedure, resolved without direct dural repair and did not complicate the patient's fusion healing. Additional anterior stabilization and fusion allowed long-term stability with bone healing that may not be achievable with posterior fixation and/or soft tissue healing alone.ConclusionsFamiliarity with the challenges and solutions presented in the case may be useful to surgeons who could face a similar challenge in the future.

26 keywords...

hide…