Neglected floating cervical spine fracture with myelopathy and Anderson lesion of D2 D3: report of an unusual case

Abstract

Introduction: The cervical spine is the most commonly affected region in traumatic spine injuries of patients with Ankylosing Spondylitis (AS), accounting for 75% of cases, followed by the thoracic and lumbar spine. The fracture may not be detectable in plain radiographs alone due to pre-existing kyphotic deformity with distorted anatomy and high-riding shoulders. Case presentation: We present a case with a floating cervical spine following a trivial trauma injury and with cervical myelopathy symptoms. After posterior fixation of the cervico-thoracic spine, the patient improved with Nurick score and mJOA score improvement. After 6 months follow up the patient was walking without support, and myelopathy symptoms were negligible. Discussion: In this patient, a posterior approach was performed. We obtained a rigid construct so that we were able to mobilize a patient on the very next day and his myelopathy symptoms improved with minimal postoperative complications.