Portal de Periódicos da CAPES

NECK INJURY - AUTOMOBILE RACING 823

1997; Lippincott Williams & Wilkins; Volume: 29; Issue: Supplement Linguagem: Inglês

10.1097/00005768-199705001-00822

1530-0315

Stephen E. Olvey, B. A. Green, Nizam Razack,

Spine and Intervertebral Disc Pathology

HISTORY - A 49-year-old Brazilian male racing car driver sustained a cervical spine injury while involved in a high speed racing accident at the Michigan International Speedway. Speed at the time of the accident was in excess of 230 miles per hour. The impact was to the left rear of the car. The driver at the scene was moving all four extremities and complaining of shortness of breath. He was placed in a rigid cervical collar, examined in the infield hospital and then airlifted to a local hospital where he was evaluated with x rays, CT Scan, and MRI of the cervical spine. He was transferred via ambulance to the University of Miami for further evaluation and treatment. PHYSICAL EXAMINATION - Neurological examination at the time of the injury was significant for lack of neck pain, full motion of all four extremities, without demonstrated neurological deficit. Within twelve hours following impact, the patient had mild neck pain and weakness of his right long finger extensors and flexors of the fourth and fifth digits. Deep tendon reflexes and the rest of his neurological examination was entirely normal. DIFFERENTIAL DIAGNOSIS: Cervical radiculopathy (C8) secondary to (a) herniated nucleus pulposis,(b) fracture of cervical spine TESTS AND RESULTS: C-spine AP and lateral radiographs: acute fracture body of C7. CT of C-spine: C7 burst fracture with C7 laminar fractures and retropulsion of bone fragments into spinal canal MRI: confirmation of above with marked cord compromise FINAL WORKING DIAGNOSIS: C7 burst fracture and instability with C8 nerve root injury presenting as radiculopathy. TREATMENT: Surgical decompression and stabilization: (a) anterior cervical corpectomy, C6-7, C7 T1 diskectomies and bilateral foraminotomies. Fusion C6 through T1 with fibular allograft and vertebral autograft and titanium plate with screws from C6 to T1; (b) posterior fusion C6 through T1 with autograft(iliac bone) using titanium cables. Neck immobilization with Miami-J collar for eight weeks.