DISLOCATION TRAUMATIQUE COMPLETE DE LA COLONNE CERVICALE SANS SEQUELLE NEUROLOGIQUE PERMANENTE

The authors present their experience with an unusual case of fracture of the lower cervical spine with complete dislocation at C6-C7 level, in a young man involved in a car accident. An initial unilateral root deficit progressed shortly after admission to hospital, to a classical Brown-Sequard syndrome. The development of a partial cord lesion in spite of the severe dislocation of the spine, could be attributed to the simultaneous 'traumatic laminotomy' and the enlargement of the neural canal at the level of the vertebral sliding, that occured as a result of bilateral fracture of the posterior arc of the 6th cervical vertebra and its separation from the anteriorly displaced vertebral body. Our management consisted in cortico-therapy and early skeletal traction with prolonged immobilization of the cervical column. The closed, rapid reduction of the dislocation under neurologic and radiologic monitoring was followed by successful alignment of the neural canal at 48 hours after injury, with progressive neurologic recovery and by 'auto-fusion' of the fractured bones with subsequent, stable and long-lasting consolidation.