European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
Internal jugular vein thrombosis in cervical spine trauma causing pulmonary embolism - a rare case report and review of the literature.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Vanamala Sai Keerthan, Kanna Rishi Mugesh, Shetty Ajoy Prasad, Rajasekaran Shanmuganathan
Аннотация
PURPOSE: To report an extremely rare occurrence of post-traumatic internal jugular vein (IJV) thrombosis leading to pulmonary embolism following cervical spine fracture dislocation.
METHODS: A 50-year-old healthy man with an AO type C C6-C7 fracture-dislocation and ASIA grade C quadriparesis underwent combined same-day posterior decompression-instrumentation and anterior cervical discectomy and fusion.
RESULTS: On post-operative day 2, acute desaturation prompted CT pulmonary angiography, which demonstrated a saddle pulmonary embolism. Lower-limb venous ultrasound was negative for deep vein thrombosis. Pre-operative MRI and neck ultrasonogram revealed absence of left IJV flow indicating a post-traumatic thrombus serving as an occult embolic source. Progressive hemodynamic instability necessitated thrombolysis, prolonged mechanical ventilation, and tracheostomy. Follow-up ultrasonography at three weeks confirmed complete IJV recanalization. At six months, the patient was independently ambulant.
CONCLUSION: Peri-vertebral venous injury may serve as a hidden source of thromboembolism in high-energy cervical spine trauma. Absence of IJV flow void on MRI should prompt focused vascular assessment. Early recognition and decisive multidisciplinary management can be lifesaving.
METHODS: A 50-year-old healthy man with an AO type C C6-C7 fracture-dislocation and ASIA grade C quadriparesis underwent combined same-day posterior decompression-instrumentation and anterior cervical discectomy and fusion.
RESULTS: On post-operative day 2, acute desaturation prompted CT pulmonary angiography, which demonstrated a saddle pulmonary embolism. Lower-limb venous ultrasound was negative for deep vein thrombosis. Pre-operative MRI and neck ultrasonogram revealed absence of left IJV flow indicating a post-traumatic thrombus serving as an occult embolic source. Progressive hemodynamic instability necessitated thrombolysis, prolonged mechanical ventilation, and tracheostomy. Follow-up ultrasonography at three weeks confirmed complete IJV recanalization. At six months, the patient was independently ambulant.
CONCLUSION: Peri-vertebral venous injury may serve as a hidden source of thromboembolism in high-energy cervical spine trauma. Absence of IJV flow void on MRI should prompt focused vascular assessment. Early recognition and decisive multidisciplinary management can be lifesaving.