Cervicomedullary Spinal Cord Injury

Spinal cord injury (SCI) is most common following trauma, typically involving motor vehicle incidents. The clinical prognosis depends on many factors, most importantly the initial grade of injury. We present a 26-year-old male who presents to the emergency department after a motor vehicle accident. He sustained significant injuries with an initial Glasgow Coma Scale of 3 and signs of complete SCI. Patients with complete SCI typically have poor outcomes despite aggressive treatment. We present a unique mechanism, treatment, and outcome of a cervicomedullary SCI through C6 retrolisthesis on C7.

• 1
  A computed tomography scan demonstrated cervicomedullary transection caused by C6-C7 facet distraction with C6 retrolisthesis on C7.
• 2
  The patient recovered the ability to track with eyes, utilize facial expression, and unilateral trapezius function to command. Neurological recovery was not made despite aggressive treatment.
• 3
  Management includes rapid dopamine and norepinephrine pressors and reduction/decompression of the C6 and C7 segments with posterior fusion for stabilization.