Flexion tear-drop fracture of the axis without neurological deficits

Abstract

Introduction :

Tear drop fracture is a cervical vertebral body fracture that has a triangular- or quadrilateral-shaped fragment that separates from antero-inferior corner and resembles a drop of water dripping from the entire vertebral body. This fracture mostly occurs at C5, C6, and C4 with common neurological injury. However, we found a rare case of C2-C3 tear drop fracture without neurological deficit. We tried to analyze the etiology and biomechanics of injury based on diagnostic images and biomechanical studies.

Methods :

We reported a 40 year-old female with tear drop of C2 and C3 vertebrae. There were history of motorcycle accident, unconsciousness, neck pain and tenderness around her cervical neck. Radiological examination showed a tear drop fracture of the antero-inferior part of C2 vertebral body and fracture of C3. The patient underwent surgery for posterior stabilization using pedicle screws and rods in C2 and C3 vertebrae.

Results:

Stable condition and normal neurological status were achieved after surgery and it remained excellent through the time. The patient was able to sit, stand, and walk after 3 days of surgery and was discharged from the hospital 5 days after surgery.

Conclusion:

A rare tear drop fracture without neurological deficit in this case was considered to be the result of combination of flexion and axial-compressive injury. Due to its common instability problem following this pattern of injury, we decided to do a surgical procedure to this patient. Further evaluation on this patient gave a very good outcome.