Management of severe traumatic flexion-distraction injuries in a multisystem trauma patient: A case report

Abstract

Study design: Case report and relevant literature review. Objective: To discuss the management of severe flexion-distraction injury of the subaxial cervical spine in a multisystem trauma patient. Summary of background data: Traumatic cervical spine injury from flexion-distraction injury can cause significant instability requiring extensive instrumentation complicated by vascular and soft tissue injuries. Methods: The medical record of a patient who suffered traumatic flexion-distraction injury was reviewed for relevant clinical and radiology data. A literature review on the management of traumatic cervical injuries was performed using the PubMed database. Results: We report a case of 21-year-old woman who suffered a C5-C6 flexion-distraction injury. After she underwent anterior cervical discectomy and fusion (ACDF), her care was transferred to the senior author (S.K.) due to the severity of the distraction. The patient returned to the OR the next day and underwent removal of implants at C5 and corpectomy with anterior and posterior instrumentation. Conclusion: There are many ways to manage a flexion-distraction injury of the cervical spine. In a polytrauma patient, the surgical strategy can become complex. We present a surgical option with an acceptable outcome. Keywords: Flexion-distraction injury, Corpectomy, Expandable vertebral body cage, Subaxial cervical spine, Fusion, Traumatic cervical spine fracture, Trauma, Three-column injury, Anterior cervical instrumentation, Posterior cervical instrumentation, 360 cervical fusion