C5 Full Body Fracture, Cervical Cage Inserted To C4 And C6. Full Recovery Possible ?

Posted on Sat, 29 Sep 2012

Question: my son recently suffered c5 full body fracture. despite all odds, has full sensory to all parts of body and is recovering. how rare is this? we call it a miracle. what is the percentage for this type of recovery?(he did have a cervical cage inserted to C4 and C6)

Answered by Dr. R.V.Sirisha Rani (1 hour later)

Hi XXXXXXX,

Thanks for posting your query.

Most cervical spine fractures occur predominantly at 2 levels. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7. These are the available stats, it is really difficult to estimate the prevelance of fractures at C5 and it is not documented anywhere.

If you view the cervical spine as 3 distinct columns: anterior, middle, and posterior. If one column is disrupted, other columns may provide sufficient stability to prevent spinal cord injury.

I am happy about the miraculous escape of your son. He would not have injured the spinal cord specially. Of course I do not have the details of the fracture and the MRI report. The higher the fracture in the neck the more would be the complications and symptoms. The recovery is easy in such cases where the spinal cord is not involved.

Cervical spinal nerves (C1 to C8) control signals to the back of the head, the neck and shoulders, the arms and hands, and the diaphragm.

Even if there is spinal cord injury, recovery of a spinal cord injury is dependant upon the type of injury. Probably it was undisplaced and hair line fracture that has caused a faster recovery. Along with it a high dose of steroids could help decrease the amount of damage to the spinal cord by reducing inflammation and swelling. Ofcourse cervical band is essential for 8 to 12 weeks after the injury and it forms the main stay of the treatment to prevent any untoward complications. Cervical cage helped a bit.

If the vertebrae are weakened from fracture,they may not be capable of supporting the normal weight from the body and protecting the spinal cord. A combination of metal screws, rods and plates may be necessary to help hold the vertebrae together and stabilize them until the bones heal.
Early surgical decompression and stabilization leads to better recovery. Aggressive physio therapy and rehabilitation after surgery also maximizes recovery. The majority of recovery occurs within the first six months after injury. Any remaining loss of function present after 12 months is much more likely to become permanent.

Hope I answered your querry.I will be happy to answer follow up querries if there are any.
Wish your son early recovery.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. R.V.Sirisha Rani (2 hours later)

i probably did not explain myself very well. according to mri: full body fracture of C5. required surgery to install titanium cervical cage from C4 thru C6 for neck stability. pieces of C5 were added back into cage at proper location. spinal sheath was not ruptured. initial prognosis was very dim. full paralysis from shoulders down, most likely on vent for remainder of life. 1 week after surgery he began moving his arms with some control, eventual sensory testing showed sensory awareness throughout his body, including feet. by 2nd week has been able to sit up on his own. lower extremity is not moving yet but promising. we were told that this type of recovery is rare considering it was a full break, not hairline fracture. i am trying to determine, as best as possible, what percentile he falls in. example: <10% exibit no paralysis, 1 in 100 or 1 in 1000 have a recovery rate this profound.... to have survived in itself is a blessing, to have him continue to improve beyond all medical expectations is beyond our comprehension. in laymans terms - can you give us the % or 'odds' that he as 'beaten' at this time.

Answered by Dr. R.V.Sirisha Rani (1 hour later)

Hi,

Thanks for getting back to me,

As many as 39% of cervical fractures have some degree of associated neurologic deficit.
Severe shock syndrome.

Spinal shock manifests as distal areflexia of a transient nature that may last from a few hours to weeks. Initially, the patient experiences a flaccid quadriplegia along with areflexia. Segmental reflexes start to return usually within 24 hours as spinal shock starts to resolve. At that point, flaccid quadriplegia changes to spastic paralysis.Eventually, total resolution can be expected.

Hope I answered your query.

Wish you good health.

Above answer was peer-reviewed by : Dr. Raju A.T