Neckpain and restriction of neck movement

56 Years old female, Mrs. R.Devika W/o Ramakrishnan presented with complaints of Neckpain and restriction of neck movement following trauma (2 months back).

Clinical examination revealed spastic neck muscles & tenderness over upper cervical spine. Range of movements (ROM) neck was grossly restricted. No neurological deficit over upper and lower limbs. X-ray showed fractured body of C4 vertebra.

MRI cervical spine was consistent with x-ray finding & there was no spinal card injury.

Provisional diagnosis of Traumatic fracture C4 vertebra secondary to ? pott's spine / ? osteoporosis (post menopausal) was made and was decided to stablise the spine anteriorly under G.A. A team of surgeons headed by Dr. S.Saravanakumar and an anaesthetic team headed by Dr. J. Srinivasan operated on the patient.


Through anterior neck incision cervical spine was reached. C4 was found to be collapsed and the adjacent disc were unhealthy (?Caseation). All the remanents of flactured vertebra were removed.

C4 Vertebral body was replaced by a tricortical bone graft from the illiac crest and stabilisation done with titanium plate and screws


Post operative period was event free. Histopathological studies confirmed tuberculous etiology of disease and was started on Anti Tuberculous Treatment & patient is symptom free now.