Pedicle Screw Fixation for Hemiplegia and Bilateral Hypoesthesia Due to C2-C3 Spinal Fracture Dislocation: A Case Report. 2023

Iglna Artha Wiguna, and I Ketut Suyasa, and Hans K Nugraha
Department of Orthopedic and Traumatology, Faculty of Medicine Udayana University / Sanglah General Hospital, Bali, Indonesia.

A 48-year-old man fell from a tree and presented to the emergency department with right-sided full hemiplegia and C3 bilateral hypoesthesia. Imaging was remarkable for a C2-C3 fracture-dislocation. The patient was effectively managed surgically with a posterior decompression and 4-level posterior cervical fixation/fusion that included pedicle screws in the axis fixation and lateral mass screws. The reduction/fixation remained stable, and the patient regained full lower extremity function and demonstrated functional upper-extremity recovery at three-year follow-up. C2-C3 fracture-dislocation is a rare but potentially fatal injury due to concomitant spinal cord injury, and its surgical management can be challenging because of the proximity of vascular and nerve structures. Posterior cervical fixation that includes axis pedicle screws can be an effective fixation option in select patients with this condition.

UI MeSH Term Description Entries
D006987 Hypesthesia Absent or reduced sensitivity to cutaneous stimulation. Hypesthesia, Tactile,Hypesthesia, Thermal,Hypoesthesia,Numbness,Impaired Sensation,Reduced Sensation,Hypesthesias,Hypesthesias, Tactile,Hypesthesias, Thermal,Hypoesthesias,Impaired Sensations,Reduced Sensations,Sensation, Impaired,Sensation, Reduced,Sensations, Impaired,Sensations, Reduced,Tactile Hypesthesia,Tactile Hypesthesias,Thermal Hypesthesia,Thermal Hypesthesias
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D006429 Hemiplegia Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; and other conditions may manifest as hemiplegia. The term hemiparesis (see PARESIS) refers to mild to moderate weakness involving one side of the body. Monoplegia,Hemiplegia, Crossed,Hemiplegia, Flaccid,Hemiplegia, Infantile,Hemiplegia, Post-Ictal,Hemiplegia, Spastic,Hemiplegia, Transient,Crossed Hemiplegia,Crossed Hemiplegias,Flaccid Hemiplegia,Flaccid Hemiplegias,Hemiplegia, Post Ictal,Hemiplegias,Hemiplegias, Crossed,Hemiplegias, Flaccid,Hemiplegias, Infantile,Hemiplegias, Post-Ictal,Hemiplegias, Spastic,Hemiplegias, Transient,Infantile Hemiplegia,Infantile Hemiplegias,Monoplegias,Post-Ictal Hemiplegia,Post-Ictal Hemiplegias,Spastic Hemiplegia,Spastic Hemiplegias,Transient Hemiplegia,Transient Hemiplegias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072039 Fracture Dislocation Fracture of a bone near an articulation with concomitant dislocation of that joint. Dislocation Fracture,Dislocation Fractures,Dislocation, Fracture,Dislocations, Fracture,Fracture Dislocations,Fracture, Dislocation,Fractures, Dislocation
D013119 Spinal Cord Injuries Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.). Myelopathy, Traumatic,Injuries, Spinal Cord,Post-Traumatic Myelopathy,Spinal Cord Contusion,Spinal Cord Laceration,Spinal Cord Transection,Spinal Cord Trauma,Contusion, Spinal Cord,Contusions, Spinal Cord,Cord Contusion, Spinal,Cord Contusions, Spinal,Cord Injuries, Spinal,Cord Injury, Spinal,Cord Laceration, Spinal,Cord Lacerations, Spinal,Cord Transection, Spinal,Cord Transections, Spinal,Cord Trauma, Spinal,Cord Traumas, Spinal,Injury, Spinal Cord,Laceration, Spinal Cord,Lacerations, Spinal Cord,Myelopathies, Post-Traumatic,Myelopathies, Traumatic,Myelopathy, Post-Traumatic,Post Traumatic Myelopathy,Post-Traumatic Myelopathies,Spinal Cord Contusions,Spinal Cord Injury,Spinal Cord Lacerations,Spinal Cord Transections,Spinal Cord Traumas,Transection, Spinal Cord,Transections, Spinal Cord,Trauma, Spinal Cord,Traumas, Spinal Cord,Traumatic Myelopathies,Traumatic Myelopathy
D016103 Spinal Fractures Broken bones in the vertebral column. Hangman Fracture,Hangman's Fracture,Fracture, Hangman,Fracture, Hangman's,Fracture, Spinal,Fractures, Spinal,Hangmans Fracture,Spinal Fracture
D065289 Pedicle Screws BONE SCREWS to be used in the pedicle of the vertebral arch. Pedicle Screw,Screw, Pedicle,Screws, Pedicle

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