Patient, male, 30 years old, was admitted to the hospital for “neck pain with numbness and weakness of left upper limb for 5 hours due to a car accident”. He felt dizziness and discomfort, chest and back pain, and could move and feel both lower limbs. The patient was immediately sent to our hospital for emergency treatment, and her head and face were debrided and bandaged. “In order to seek further treatment, the patient was admitted to our department for emergency treatment of “cervical spine trauma”. Pressure pain in the left neck and shoulder, scapular region and right wrist.
Sensation and muscle strength of the right upper extremity were normal.
Tactile sensation and pain-temperature sensation were absent in the left lateral shoulder. Left deltoid muscle strength was grade 0, left biceps muscle strength was grade 0, left triceps muscle strength was grade IV, left wrist extension and wrist flexion muscle strength was grade IV, left hand grip strength was grade IV. The left biceps reflex was not elicited, the left triceps reflex was present, and the right biceps and triceps reflexes were present. Hoffmann’s sign was negative bilaterally. The muscle strength of both lower extremities was normal, bilateral knee reflexes were not elicited, and bilateral Achilles tendon reflexes were symmetrical. Babinski’s sign was negative bilaterally.
Auxiliary examinations: cervical spine X-ray: the cricothyroid joint gap was wide on the left and narrow on the right, and the left T1 transverse rib joint was dislocated.
Cervical spine CT: cervical 6 arch fracture, cervical 6 vertebral body slipped forward.
MRI of cervical spine: slipped cervical 6 vertebrae, herniated cervical 6-7 disc with spinal stenosis, bulging cervical 3-4 and cervical 4-5 discs, obvious swelling of soft tissues in the left neck, and slightly thickened cervical medulla in the middle and upper segments.
Chest CT: left pleural effusion, fracture of the left first rib, left transverse process of thorax 2-5 and left scapula. Left scapula X-ray: left scapula fracture intraoperative hyperextension hyperflexion position film Postoperative X-ray The patient’s postoperative neck pain disappeared significantly, single left upper limb lifting was difficult, and the deltoid muscle atrophy.
The left lateral shoulder sensation disappeared. Right deltoid muscle strength grade V, left deltoid muscle strength grade 0, right biceps muscle strength grade V, triceps muscle strength grade V, left biceps muscle strength grade 0, left triceps muscle strength grade IV, left wrist extension and wrist flexion muscle strength grade IV, right wrist extension and wrist flexion muscle strength V, left hand grip strength (IV+) grade, right hand grip strength grade V Electromyography showed: left upper brachial plexus nerve trunk injury