Traumatic Cervical Disc Protruding Postero-Laterally Mimicking Lateral Flexion Type Injury of Cervical Spine: a Case Report

We report a case of a 35-year-old man injured in a road traffic accident and who sustained a lateral flexion type of cervical spine injury with no obvious vertebral fracture. Allen and Ferguson in 1980 classified cervical spine injuries into 6 types, out of which lateral flexion type is less common. In lateral flexion type of injuries, there is always a bony fracture unilaterally. In this case, we report a cervical spine injury which mimics lateral flexion type of injury without any bony fracture. We found that the cervical disc at C3–C4 was protruded postero-laterally leading to subluxation and unilateral dilatation of the facet joint. This injury does not fit to any classification. Manual reduction was attempted which failed, and then the patient was taken up for surgery. Anterior decompression was planned, and during surgery the disc was found to be protruded postero-lateral, and reduction was achieved after removal of the disc. Iliac crest bone graft was placed and fixed with a plate. The lateral flexion type of cervical spine injuries occurs at a low frequency. Most of them require surgery. Manual reduction by traction should not be attempted, and careful examination of radiology along with MRI is necessary.