Sakayama Kenshi, Kidani Teruki, Matsuda Yoshiro, Sugawara Yoshifumi, Shibata Taihoh, Yamamoto Haruyasu
Department of Orthopedic Surgery, Ehime University School of Medicine, Ehime, Japan.
Spine (Phila Pa 1976). 2005 May 15;30(10):E269-71. doi: 10.1097/01.brs.0000162533.02807.c9.
This was a case of a child who recovered completely after spinal cord surgery complicated by C2-C3 fracture dislocation.
To clarify the important issue with regard to the diagnosis and treatment of possible spinal cord injury complicated by C2-C3 fracture dislocation in children.
Reports on spinal cord injury complicated by C2-C3 fracture dislocation in children who recovered completely after surgery are very rare. Moreover, there are no reports of cases in which described MRI and magnetic resonance angiography obtained 5 years after surgery.
A 4-year-old girl with complete fracture dislocation of C2-C3 and spinal cord injury of Frankel B because of a traffic injury. A middle incision was made in a prone position under general anesthesia, and C2-C3 was fixed with interlaminal wiring according to the McGraw modified method.
The postoperative course was excellent, and the patient recovered completely. An MRI performed 5 years after surgery revealed no definitive abnormality in spinal cord and patency of vertebral arteries.
This was a very rare case of spinal cord injury complicated C2-C3 fracture dislocation in children. The present case is of interest in that it demonstrated the possibility of recovery in a child from spinal cord injuries of Frankel B immediately after injury, if complex injuries in multiple organs are controlled by systemic management.
这是一例脊髓手术后合并C2 - C3骨折脱位但完全康复的儿童病例。
阐明儿童C2 - C3骨折脱位合并可能的脊髓损伤的诊断和治疗方面的重要问题。
关于儿童C2 - C3骨折脱位合并脊髓损伤且术后完全康复的报道非常罕见。此外,尚无术后5年的MRI和磁共振血管造影相关病例报道。
一名4岁女童因交通伤导致C2 - C3完全骨折脱位及Frankel B级脊髓损伤。在全身麻醉下俯卧位做正中切口,按照McGraw改良法用椎板间钢丝固定C2 - C3。
术后过程良好,患者完全康复。术后5年进行的MRI显示脊髓无明确异常,椎动脉通畅。
这是一例非常罕见的儿童C2 - C3骨折脱位合并脊髓损伤病例。本病例的意义在于它表明,如果通过全身管理控制多器官的复合伤,受伤后即刻为Frankel B级脊髓损伤的儿童有可能康复。