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Research ArticleCervical Spine

“Floating Cervical Spine Injuries”: Craniocervical Dissociation with Associated, Noncontiguous, Unstable Cervical or Cervicothoracic Spine Fracture

Mario Taylor, Celeste Tavolaro, Carlo Bellabarba and Richard J. Bransford
International Journal of Spine Surgery October 2021, 15 (5) 862-870; DOI: https://doi.org/10.14444/8111
Mario Taylor
Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
MD
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Celeste Tavolaro
Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
MD
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Carlo Bellabarba
Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
MD
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Richard J. Bransford
Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
MD
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    Figure 1

    Cervical spine sagittal reformatted computed tomography scan showing (A) asymmetric widening of the right atlantooccipital joint (AOJ) space consistent with dissociation. Arrow shows significant distraction injury at C5–6 with approximately 2.0 cm in cranial caudal distraction. (B) Left AOJ with more subtle widening and subluxation as well.

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    Figure 2

    Postoperative (first stage) computed tomography image. Occiput-C2 posterior spinal instrumentation and fusion (PSIF) in near anatomic alignment and C5–C6 PSIF mild residual widening of the intervertebral space.

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    Figure 3

    Postoperative x-ray lateral view (second stage) showing cervical anatomic alignment restored. Occiput-C2 posterior spinal instrumentation and fusion (PSIF) for the atlantooccipital dissociation. Interval C5–6 PSIF for the severe C5–6 distraction injury shows significant improvement in alignment.

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    Figure 4

    Cervical spine sagittal reformatted computed tomography scan showing (A) right occiput-C1 widening, right C1–C2 widening, and a dislocated right T1–T2 facet. (B) T1–T2 flexion distraction injury with bilateral jumped facets. (C) Left occiput-C1 with normal appearance but widening of C1–C2 and left T1–T2 dislocated facet.

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    Figure 5

    Postoperative x-ray (lateral view) demonstrating normal alignment after T1, T2 posterior spinal instrumentation and fusion (PSIF), and occiput-C2 PSIF.

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International Journal of Spine Surgery
Vol. 15, Issue 5
1 Oct 2021
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“Floating Cervical Spine Injuries”: Craniocervical Dissociation with Associated, Noncontiguous, Unstable Cervical or Cervicothoracic Spine Fracture
Mario Taylor, Celeste Tavolaro, Carlo Bellabarba, Richard J. Bransford
International Journal of Spine Surgery Oct 2021, 15 (5) 862-870; DOI: 10.14444/8111

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“Floating Cervical Spine Injuries”: Craniocervical Dissociation with Associated, Noncontiguous, Unstable Cervical or Cervicothoracic Spine Fracture
Mario Taylor, Celeste Tavolaro, Carlo Bellabarba, Richard J. Bransford
International Journal of Spine Surgery Oct 2021, 15 (5) 862-870; DOI: 10.14444/8111
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Keywords

  • spinal cord injury
  • craniocervical dissociation
  • floating cervical spine
  • spine fracture
  • spine dislocation
  • subaxial dislocation

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