TY - JOUR
T1 - Epidural hematoma after immobilization of a "hangman's" fracture
T2 - Case report and review of the literature
AU - Buchowski, Jacob M.
AU - Riley, Lee H.
PY - 2005/5
Y1 - 2005/5
N2 - Background context: Neurologic deterioration after immobilization of traumatic spondylolisthesis of the axis rarely occurs because of the decompressive nature of the injury itself and the large amount of space available for the cord in the upper cervical spine. Purpose: To document neurologic deterioration after reduction (without the use of traction) and halo immobilization of a Type IIA traumatic spondylolisthesis of the axis (hangman's fracture) secondary to an epidural hematoma. Study design/setting: Case report. Patient sample and outcome measures: The patient population consisted of one patient; no outcome measures were used. Methods: The medical record and radiographic studies of a 27-year-old patient involved in a motor vehicle crash that resulted in a traumatic spondylolisthesis of the axis were retrospectively reviewed, and a review of the English literature was performed. Results: Upon evaluation, the patient was found to have, in addition to other injuries, a Type IIA hangman's fracture of the C2 vertebra, which was stabilized in a halo. Shortly thereafter, the patient developed a gradual progressive neurologic deficit. Magnetic resonance imaging revealed the presence of a large epidural hematoma with cord compression treated with posterior laminectomy and transdural decompression of an anterior hematoma. Postoperatively, the patient's neurologic examination improved and returned to normal within 6 months. Conclusion: An epidural hematoma can occur after traumatic spondylolisthesis of the axis, but its symptoms may not present until after the spondylolisthesis is treated.
AB - Background context: Neurologic deterioration after immobilization of traumatic spondylolisthesis of the axis rarely occurs because of the decompressive nature of the injury itself and the large amount of space available for the cord in the upper cervical spine. Purpose: To document neurologic deterioration after reduction (without the use of traction) and halo immobilization of a Type IIA traumatic spondylolisthesis of the axis (hangman's fracture) secondary to an epidural hematoma. Study design/setting: Case report. Patient sample and outcome measures: The patient population consisted of one patient; no outcome measures were used. Methods: The medical record and radiographic studies of a 27-year-old patient involved in a motor vehicle crash that resulted in a traumatic spondylolisthesis of the axis were retrospectively reviewed, and a review of the English literature was performed. Results: Upon evaluation, the patient was found to have, in addition to other injuries, a Type IIA hangman's fracture of the C2 vertebra, which was stabilized in a halo. Shortly thereafter, the patient developed a gradual progressive neurologic deficit. Magnetic resonance imaging revealed the presence of a large epidural hematoma with cord compression treated with posterior laminectomy and transdural decompression of an anterior hematoma. Postoperatively, the patient's neurologic examination improved and returned to normal within 6 months. Conclusion: An epidural hematoma can occur after traumatic spondylolisthesis of the axis, but its symptoms may not present until after the spondylolisthesis is treated.
KW - Axis
KW - Hangman's fracture
KW - Spine
KW - Traumatic spondylolisthesis
UR - http://www.scopus.com/inward/record.url?scp=18144378812&partnerID=8YFLogxK
U2 - 10.1016/j.spinee.2004.09.005
DO - 10.1016/j.spinee.2004.09.005
M3 - Article
C2 - 15863089
AN - SCOPUS:18144378812
VL - 5
SP - 332
EP - 335
JO - Spine Journal
JF - Spine Journal
SN - 1529-9430
IS - 3
ER -