Date: Tue, 07 Sep 1999 21:18:08 -0400

Subject: C7 Fx

From: Charles Blitzer

24 yo male dove into pool. Had transient paresthesia all 4 extremities with prompt, complete resolution of neurologic sx's. C7 body fx with > 50% canal compromise due to large retropulsed fragment. No apparent posterior element disruption. Currently well aligned in Halo.

? decompress & fuse vs. nonop Rx.

Thanks for your thoughts.- Charles Blitzer

Date: Wed, 8 Sep 1999 11:26:24 EDT

From: Tom DeCoster

I have treated similar patient with C7 body fracture with transient neurosymptoms nonoperatively, He healed with minimal additional anterior body collapse and a constellation of mild symptoms (headaches, neck aches,... for months). There were a variety of concerns about appropriate activity after a year and we got several additional opinions. Some recommended late corpectomy and fusion but patient and family declined. He went on to college and seems to be doing OK.

I think nonoperative treatment is reasonable and probably the safest treatment. You could justify corpectomy and fusion based upon theoretical and anatomical-radiologic considerations. C7 isn't the easiest to access but is possible.

T DeCoster