Injuries of the lower cervical spine associated with widening of the spinal canal

In this paper, we present 17 cases with injury of the lower cervical spine associated with widening of the spinal canal. This was due to bilateral fracture of the pedicles of the neural arch, where the body of the injured vertebra is displaced anteriorly, while the posterior elements of the vertebra remain in situ. Eleven patients were male and six female, between 32 and 53 years of age. Ten of them were involved in a road traffic accident, while seven had a fall on the head. We distinguished two types of injury: Type I with anterior displacement of the injured vertebra (12 cases) and Type II with impaction of the injured vertebral body on the vertebra below (five cases). Thirteen patients were without neurological complications, two had root lesions, while two had tetraplegia from a point higher than the injury level. This was due to an extensive anterior displacement of the injured vertebra and of the whole spine above, associated with dislocation of the vertebra above the injury and damage to the spinal cord. The cases with anterior displacement of the injured vertebra are unstable and need spinal fusion after prior reduction, while the rest can be treated non-operatively with head traction followed by bracing until stable intervertebral union is achieved.