Recently, I did an emergent surgery for a middle age male who had broken neck after a fall at work. He came in with weakness of the right upper limb from a herniated disc. Mechanism of injury was likely a flexion distraction force which tore through his cervical disc space and fractured the left posterior facet joint.
A CT scan showed a loss of his spinal alignment with left posterior facet dislocation. MRI done showed a herniated disc fragment pressing on his spinal cord and nerves.
I went in on him the very night as there was a possibility of progressive weakness with cord swelling. Luckily the dislocation was reduced on table. I proceeded with an anterior cervical decompression with removal of the herniated disc fragments. This was followed by surgical stabilization with an implant and screws into the bone to hold the joint.
He woke up immediately feeling better and the weakness got better over the next couple of days. He will likely make a good recovery over weeks and return to work in a couple of months.
Severe high impact fractures of the spine is a catastrophe. Many a time, it is associated with spine cord injuries that do not recover and patient ends up in a wheelchair. Early assessment and surgical intervention can arrest the degree of injury and possibly improve outcomes — like the patient I operate on!
HC Spine & Orthopaedics 