Mark W. McFarland, DO
Most people are aware of basic spine anatomy – how the bones of the spine sit atop one another, sandwiched between cushiony discs filled with watery gel that act as shock absorbers. These vertebrae, and the attached muscles and ligaments give us amazing strength and stability to lift heavy weights and the flexibility to do backbends and yoga. However, when things go wrong, our spinal bones can fracture and even become dislocated. In this series of articles, I will discuss the complete traumatic spondylolisthesis of the cervical spine (slipped vertebra caused by injury), how it is caused, its symptoms, how it is diagnosed, and treated.
A complete dislocation fracture (DF) of the cervical spine is usually considered the worst-case scenario because it most often results in spinal cord injury, although there are rare cases in which this has been documented not to have happened. Because it is so flexible, the cervical spine is easily subluxated. Spinal cord injury at the cervical level typically means some sort of neurologic deficit will be present, whether it be complete quadriplegia, or tetraplegia, or less.
The causes of a traumatic spondylolisthesis are the usual suspects: motor vehicle accidents, high-impact contact sports injuries, being hit by an object at velocity and falls from heights. It is important to stress the incredible force that must hit the vertebra to cause a massive failure along its entire structure, so that it not only fractures but is also knocked out of place. Because the spinal cord runs through the middle of the vertebral body, this force almost always causes some traumatic injury, if not complete severing of the spinal cord. Even the most amateur of observers who views an x-ray of a complete dislocation fracture of the spine will know this is a life-changing injury.
A good example of this type of injury would be Buffalo Bills’ player Kevin Everett who suffered a spinal dislocation fracture in the cervical column during a collision with Denver’s kick-returner in 2007. After lying on the football field for 15 minutes during which he almost died, Everett was rushed to the hospital, paralyzed from the neck down. After five hours of surgery and an experimental procedure, over time and with much rehab, Everett miraculously regained use of his lower body and now is almost fully functional and walking.
Symptoms of a complete dislocation fracture of the spine will be dependent upon where it occurs in the vertebral column in the neck and the amount of damage that is done to the spinal cord. I will address the symptoms in the next article in this series.