Veras L M, Pedraza-Gutiérrez S, Castellanos J, Capellades J, Casamitjana J, Rovira-Cañellas A
Department of Orthopedic Surgery and MR Unit (Department of Radiology), Vall d'Hebron University Hospital, Barcelona, Spain.
Spine (Phila Pa 1976). 2000 May 1;25(9):1171-7. doi: 10.1097/00007632-200005010-00019.
A retrospective study of vertebral artery injury diagnosed during the last 6 years in our institution.
To determine the clinical and radiologic features of vertebral artery injury.
Extracranial occlusion of the vertebral artery associated with cervical spine fracture is uncommon and can cause serious and even fatal neurologic deficit due to back lifting and cerebellar infarction. Magnetic resonance imaging and magnetic resonance angiography are extremely helpful in the examination of acute injuries of the cervical spine.
Magnetic resonance imaging and magnetic resonance angiography were performed at the time of injury.
The authors reviewed six patients with cervical spine fractures who were diagnosed with a unilateral occlusion of the vertebral artery by means of magnetic resonance imaging/magnetic resonance angiography. One patient had signs of vertebrobasilar insufficiency and another with complete cord lesion had cerebellar and back lifting infarctions. Surgical anterior spinal fusion was performed in five patients, and one was treated by traction and orthosis. At the time of discharge, five patients had no vertebrobasilar symptoms, and the patient who experienced vertebrobasilar territory infarctions showed no progression of the neurologic damage.
Vertebral artery injury should be suspected in cervical trauma patients with facet joint dislocation or transverse foramen fracture. Magnetic resonance imaging/magnetic resonance angiography is a helpful test to rule out vascular injury. Vertebral artery injury affects the extracranial segment at the same level as the cervical fracture. This is a retrospective review that did not permit drawing conclusions about the effects of early surgical stabilization in the treatment of cervical spine injuries with associated vertebral artery injury; however, surgical stabilization may avoid propagation and embolization of the clot located at the site of the lesion.
对我院过去6年诊断出的椎动脉损伤进行回顾性研究。
确定椎动脉损伤的临床和放射学特征。
与颈椎骨折相关的椎动脉颅外闭塞并不常见，可因后循环梗死和小脑梗死导致严重甚至致命的神经功能缺损。磁共振成像和磁共振血管造影对颈椎急性损伤的检查极为有用。
在损伤时进行磁共振成像和磁共振血管造影。
作者回顾了6例颈椎骨折患者，这些患者通过磁共振成像/磁共振血管造影被诊断为单侧椎动脉闭塞。1例患者有椎基底动脉供血不足的体征，另1例完全性脊髓损伤患者发生了小脑和后循环梗死。5例患者接受了前路脊柱融合手术，1例接受了牵引和矫形治疗。出院时，5例患者无椎基底动脉症状，发生椎基底动脉区域梗死的患者神经损伤无进展。
颈椎小关节脱位或横突孔骨折的创伤患者应怀疑有椎动脉损伤。磁共振成像/磁共振血管造影是排除血管损伤的有用检查。椎动脉损伤影响与颈椎骨折同一水平的颅外段。这是一项回顾性研究，无法就早期手术稳定在治疗伴有椎动脉损伤的颈椎损伤中的作用得出结论；然而，手术稳定可能避免位于病变部位的血栓的扩散和栓塞。
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