Jankowski Roman, Zukiel Ryszard, Nowak Stanisław
Katedry i Kliniki Neurochirurgii i Neurotraumatologii Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu.
Neurol Neurochir Pol. 2003;37(4):955-62.
A 32 year-old woman with cervico-brachial pain and progressive neurological disorders was admitted to the Department and Clinic of Neurosurgery and Neurotraumatology of the K. Marcinkowski University of Medical Sciences in Poznań. Neurological examination revealed right hemiparesis with muscular atrophy in the right upper limb, progressing in the past 3 months. MRI demonstrated relatively large herniations of C4-C5 and C5-C6 discs with spinal and nerve compressions. A surgery was carried out. Discectomy of C4-C5 and C5-C6 discs was performed using the anterior vertebral approach. After the removal of C4-C5 and C5-C6 discs and C5 vertebral body a fragment of the iliac bone strut was wedged between C4 and C6 vertebral bodies. The bone graft was fixed to C4 and C6 vertebral bodies with a titanium plate. Within 6 hours after the surgery the patient developed a complete loss of motor functions in the upper and lower limbs. MRI scan of the cervical spine showed a huge anterior epidural hematoma compressing the spinal cord. An emergency re-operation and removal of the hematoma was performed by the anterior approach. A complete neurological recovery followed during the first 24 postoperative hours.
一名32岁患有颈臂疼痛和进行性神经功能障碍的女性被收治入波兹南的K.马尔钦科夫斯基医科大学神经外科和神经创伤科及诊所。神经学检查发现右侧偏瘫，右侧上肢肌肉萎缩，在过去3个月中病情进展。磁共振成像（MRI）显示C4 - C5和C5 - C6椎间盘有较大突出，伴有脊髓和神经受压。进行了手术。采用前路椎体入路对C4 - C5和C5 - C6椎间盘进行了椎间盘切除术。在切除C4 - C5和C5 - C6椎间盘及C5椎体后，将一块髂骨支撑骨块楔入C4和C6椎体之间。用钛板将骨移植块固定于C4和C6椎体。术后6小时内，患者出现上下肢运动功能完全丧失。颈椎MRI扫描显示巨大的硬膜外前血肿压迫脊髓。通过前路进行了紧急再次手术并清除血肿。术后24小时内神经功能完全恢复。
