A Case Report of an Unstable Cervical Spine Fracture: Parallels to the Thoracolumbar Chance Fracture

Abstract 

Objective

To discuss the case of a 40-year-old woman who had a cervical spine fracture similar in appearance to a Chance fracture and to discuss its radiographic appearance.

Clinical Features

A 40-year-old woman sought chiropractic care for neck pain and weakness in both arms after a motor vehicle accident. Neck flexion worsened the weakness in her upper extremities, her radiating neck pain, and upper extremity pain. A transverse fracture through the spinous process of C6 and narrowed C6 disk space was noted on plain film radiographs. Magnetic resonance imaging findings were consistent with a large midline extruded disk herniation at the C6-7 level with marked extrinsic compression on the cervical cord in addition to the fracture. These findings were similar to a lumbar spine Chance fracture.

Intervention and Outcome

The patient was referred for surgical consultation, and discectomy with fusion of C6-7 was performed. After the surgery, the upper extremity pain and weakness subsided. Postsurgical care included chiropractic adjustments with a handheld spring-loaded adjusting instrument and physiotherapy.

Conclusion

The radiographic features of an unusual cervical spine fracture with the characteristics of a Chance-type fracture are discussed.