Successful management of severe pediatric cervical trauma emphasizing the role of surgical stabilization and intensive rehabilitation in achieving complete recovery: a case report.

BACKGROUND

Traumatic cervical spinal cord injury is a devastating condition with unpredictable neurological outcomes. American Impairment Scale grade A lesions, particularly those associated with burst fractures, are typically linked to poor recovery.

CASE PRESENTATION: A 15-year-old Syrian male presenting with a C5 burst fracture and a 20.2 mm intramedullary lesion (American Impairment Scale grade A) underwent successful plate and cylinder fixation. Following intensive postoperative rehabilitation, the patient demonstrated an exceptional clinical trajectory, transitioning from complete paraplegia and upper-extremity weakness to full functional ambulation and motor recovery within three months (refer to the Graphical Abstract).

CONCLUSIONS

This case demonstrates that complete neurological recovery may be achievable in pediatric patients following severe cervical burst fractures and extensive spinal cord contusions, despite an initial American Impairment Scale grade A presentation. The findings suggest that the combination of early surgical stabilization and intensive rehabilitation can optimize outcomes, challenging traditional prognostic expectations for large intramedullary lesions.