Lab Studies:
CBC: WBC 1.66 RBC: 4.04, H/H 12.8/39.2, MCV 97.0, Plt 54 CMP/PT/INR: WNL
Other Studies:
X-rays of the left arm Case Photo #1 Case Photo #2 , elbow, and scapula: No fractures or malalignment noted.
X-rays of cervical spine: Large bone spur noted on anterior aspect of C6.
X-rays of thoracic spine: normal alignment
CT Cervical Spine: Fracture of posterior elements on left at C7 to C6/7 and C7-T1 facet articulations. Small fracture of the left C6 vertebral process with narrowing of the neuroforamen from fracture fragments Case Photo #4 Case Photo #5
CT Thoracic Spine: Fracture of medial 5th and 6th rib heads at costotransverse articulations, and of inferolateral T6 endplate.
MRI Cervical Spine: High grade tear of the anterior longitudinal ligament and anterior annulus fibrosus of the C5/6 disc. Mild posterior longitudinal ligament injury with C6/7 disc extrusion with severe central stenosis. Fracture left lateral C7 mass and fracture of C6 osteophyte with normal alignment. Case Photo #3
Perioperative EMG: within normal limits.
Consultations:
Orthopedic Surgery and Hematology/Oncology
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.