Complete C4-C5 Dislocation Secondary to Shallow Water Diving in a Child: a case-based update

Luxação Completa de C4-C5 Secundária a Mergulho em Águas Rasas em uma Criança: atualização baseada em caso

• Luís Eduardo Oliveira Matos (1)    
• Gabriel Sá Figueiredo (1)    
• Matheus Brasil Câmara Monteiro (1)    
• Mateus Aragão Esmeraldo (1)    
• Keven Ferreira da Ponte (2) (3)    
• Gerardo Cristino-Filho (3) (4)    
• Paulo Roberto Lacerda Leal (3) (4)    

• https://doi.org/10.22290/jbnc.2023.340106
• J Bras Neurocirur 34(1): 124-129, 2023

Resumo

Introdução: A lesão medular pediátrica é rara, especialmente secundária ao mergulho em águas rasas, com poucos casos registrados na literatura. Devido à falta de padronização no diagnóstico e manejo desses casos, cada um deles requer uma abordagem individualizada. Relato do caso: Paciente do sexo feminino, 10 anos de idade, evoluiu com tetraparesia e nível sensitivo C5 secundário a trauma raquimedular após mergulho em águas rasas. A tomografia computadorizada revelou luxação completa de C4-C5, o que levou a uma abordagem neurocirúrgica precedida por uma manobra manual intraoperatória para redução da luxação. Após a redução cirúrgica completa, a paciente apresentou melhora neurológica imediata significativa. Conclusão: Apresentamos uma discussão e revisão de literatura sobre este caso de trauma raquimedular pediátrico, com ênfase no manejo, visando contribuir para uma melhor padronização do procedimento cirúrgico nestes casos.

Palavras-chave

Trauma raquimedular pediátrico; Mergulho em águas rasas; Luxação cervical; Manejo de traumas raquimedulares

Abstract

Background: Pediatric spinal cord injury (PSCI) is rare, especially secondary to shallow water diving, with only a few cases recorded in the literature. Due to the low standardization in the diagnosis and treatment of PSCI, each of these cases requires a personalized approach. Case presentation: A 10-year-old female patient presented with tetraparesis and C5 sensory level secondary to spinal trauma due to shallow water diving. Computed Tomography (CT) revealed complete C4-C5 dislocation, which led to a neurosurgical approach preceded by an intraoperative manual maneuver to reduce the dislocation. Following complete surgical dislocation reduction, the patient had significant immediate neurological improvement. Conclusion: Here, we present a discussion and literature review on this case of PSCI, with emphasis on management, aiming to contribute to better standardization of the surgical procedure in these cases.

Keywords

Pediatric spinal cord injury; Shallow water diving; Cervical dislocation; Spinal trauma management

References

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1 Medical student, Department of Neurosurgery, Federal University of Ceará, Sobral, CE, Brazil.

2 MD, MSc, Department of Neurosurgery, Federal University of Ceará, Sobral, CE, Brazil.

3 Neurosurgeon, Department of Neurosurgery, Santa Casa de Misericórdia’s Hospital, Sobral, CE, Brazil.

4 MD, PhD, Department of Neurosurgery, Federal University of Ceará, Sobral, CE, Brazil.

 

Received Jan 1, 2023

Accepted Feb 6, 2023