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Rare case of real-time observation of paralytic deterioration after cervical dislocation in the hyperacute phase

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Title: Rare case of real-time observation of paralytic deterioration after cervical dislocation in the hyperacute phase
Authors: Endo, Tsutomu Browse this author →KAKEN DB
Suda, Kota Browse this author
Fukui, Takafumi Browse this author
Matsumoto, Satoko Browse this author
Komatsu, Miki Browse this author
Ota, Masahiro Browse this author
Ushiku, Chikara Browse this author
Yamane, Junichi Browse this author
Minami, Akio Browse this author →KAKEN DB
Takahata, Masahiko Browse this author →KAKEN DB
Iwasaki, Norimasa Browse this author →KAKEN DB
Keywords: Spinal cord injury
Complete paralysis
Issue Date: 2-May-2022
Publisher: BioMed Central
Journal Title: BMC musculoskeletal disorders
Volume: 23
Issue: 1
Start Page: 412
Publisher DOI: 10.1186/s12891-022-05345-2
Abstract: Background There have been no prior reports of real-time detailed records leading to complete quadriplegia immediately after fracture dislocation in high-energy trauma. Here, we report a case of cervical dislocation in which the deterioration to complete motor paralysis (modified Frankel B1) and complete recovery (Frankel E) could be monitored in real time after reduction in the hyperacute phase. Case presentation A 65-year-old man was involved in a car accident and sustained a dislocation at the C5/6 level (Allen-Ferguson classification: distractive flexion injury stage IV). His paralysis gradually deteriorated from Frankel D to C 2 hours after the injury and from Frankl C to B 5 hours after the injury. His final neurological status immediately before reduction was Frankel B1 (complete motor paralysis with sensation only in the perianal region). Reduction was completed within 6 h and 5 min after injury, and spinal fusion was subsequently performed. The patient exhibited rapid motor recovery immediately after surgery, and was able to walk independently on postoperative day 14. Conclusions This case suggests that there is a mixture of cases in which the spinal cord has not been catastrophically damaged, even if the patient has complete motor paralysis. Prompt reduction has the potential to improve neurological function in such cases.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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