Single Stage Global Fusion for Fracture Subluxation of Cervical Spine Injury-Case Report

Abstract

Introduction: Fracture subluxation following cervical spine injury is commonly encountered. Fracture subluxation can result in a serious spinal injury due to compression of the spinal cord. Though decompression of spine is done either anterior or posterior depending upon the site of compression, there is no consensus regarding the stabilization of spine either anterior or posterior or both after decompression of the spinal cord. Global fusion involves combined anterior and posterior stabilization of cervical spine. We report a case of fracture subluxation of C6 over C7 vertebra for whom global fusion was done in a single stage to prevent neurological deficit.  Materials: Thirty six year old male patient who was a construction worker was brought to casualty after history of fall from height of 20 feet. Patient was immediately immobilized with Philadelphia collar and examined clinically for neurological deficits. On examination patient had no motor weakness and had hypoesthesia in C8 dermatome bilaterally. Radiological examination was done and patient was taken up for surgery. Global fusion following decompression was done for the patient. Results: Anterior decompression with bone grafting and anterior cervical plate fixation followed by posterior stabilization with interspinous wiring and bone grafting was done. Postoperative period was uneventful. Patient recovered from hypoesthesia and immediate mobilization was started. Conclusion: The combined single-stage anterior and posterior stabilization procedure represents a viable option in the treatment of patients with fracture subluxation following cervical spine injury than with single anterior or posterior approach alone.