Radiologically Devastating Yet Neurologically Intact: A Rare Case of Ambulatory C6-C7 Translational Injury with Bilateral Facet Dislocation and Vertebral Artery Thrombosis.

INTRODUCTION: Subaxial cervical translational injuries with bilateral facet dislocation are among the most unstable spinal injuries and are generally associated with severe neurological compromise. CASE REPORT: A 30-year-old male sustained a high-velocity road traffic accident and presented with bilateral upper limb weakness, yet remarkably remained ambulatory with preserved bowel-bladder function. Radiological evaluation revealed a C6-C7 translational injury with bilateral facet dislocation, burst fracture of C7, traumatic disc disruption, posterior ligamentous complex injury, spinal cord contusion, and complete thrombosis of the left vertebral artery. The patient underwent posterior cervical decompression and stabilization using lateral mass screw fixation. Progressive neurological recovery occurred, with complete motor recovery documented at 6-month follow-up. CONCLUSION: This case highlights the striking discordance between radiological severity and neurological status. Early diagnosis, meticulous clinical evaluation, prompt surgical stabilization, and structured rehabilitation are essential in such rare presentations to prevent secondary neurological deterioration and optimize outcomes.