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一名脊髓损伤合并C2-3骨折脱位后完全康复的儿童:病例报告。

A child who recovered completely after spinal cord injury complicated by C2-3 fracture dislocation: case report.

作者信息

Sakayama Kenshi, Kidani Teruki, Matsuda Yoshiro, Sugawara Yoshifumi, Shibata Taihoh, Yamamoto Haruyasu

机构信息

Department of Orthopedic Surgery, Ehime University School of Medicine, Ehime, Japan.

出版信息

Spine (Phila Pa 1976). 2005 May 15;30(10):E269-71. doi: 10.1097/01.brs.0000162533.02807.c9.

Abstract

STUDY DESIGN

This was a case of a child who recovered completely after spinal cord surgery complicated by C2-C3 fracture dislocation.

OBJECTIVES

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.

SUMMARY OF BACKGROUND DATA

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

研究设计

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。

目的

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。

背景资料总结

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。

方法

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。

结果

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。

结论

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。

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