高能创伤并发强直阵挛性癫痫导致的创伤性脊柱滑脱。
Traumatic spondyloptosis resulting from high-energy trauma concurrent with a tonic-clonic seizure.
作者信息
Daniels Alan H, Deodhar Atul A, Hart Robert A
机构信息
Department of Orthopedics and Rehabilitation, Oregon Health and Science University, Portland, OR 97201, USA.
出版信息
Spine J. 2009 Jan-Feb;9(1):e1-4. doi: 10.1016/j.spinee.2007.10.030. Epub 2007 Dec 21.
BACKGROUND CONTEXT
Traumatic lumbosacral dislocation injuries are rare, high-energy injuries that are challenging to surgically manage.
PURPOSE
To report a patient with a traumatic spondyloptosis of L5 on S1 as a result of bilateral pedicle fractures of L4 and L5 occurring during a motor vehicle accident, concurrent with a tonic-clonic seizure. The mechanism and treatment of the injury are discussed.
STUDY DESIGN
Clinical case report and literature review.
METHODS
A staged circumferential fusion was performed with posterior reduction of L5 to the sacrum and instrumentation and fusion from L2 to the pelvis, followed 12 days later by anterior diskectomies and arthrodesis from L3 to S1.
RESULTS
Near anatomic reduction and solid fusion were obtained and maintained at 3-year follow-up. The patient remained neurologically intact in all lumbosacral roots throughout the course of treatment.
CONCLUSIONS
The injury pattern described is quite rare. This case of multilevel, bilateral pedicle fracture with traumatic L5-S1 spondyloptosis was successfully treated by circumferential reduction and arthrodesis without neurological injury.
背景
创伤性腰骶椎脱位损伤较为罕见，属于高能量损伤，手术治疗颇具挑战性。
目的
报告一名患者，其在机动车事故中因L4和L5双侧椎弓根骨折导致L5向S1创伤性椎体滑脱，并伴有强直阵挛性发作。探讨了损伤机制及治疗方法。
研究设计
临床病例报告及文献综述。
方法
分阶段进行环形融合术，先行L5向骶骨后路复位并进行L2至骨盆的内固定及融合，12天后再行L3至S1的前路椎间盘切除术及椎间融合术。
结果
获得了近乎解剖复位及坚固融合，并在3年随访中得以维持。在整个治疗过程中，患者所有腰骶神经根的神经功能均保持完好。
结论
所描述的损伤模式非常罕见。该例多级双侧椎弓根骨折伴创伤性L5-S1椎体滑脱通过环形复位及椎间融合术成功治疗，未出现神经损伤。
Zotero 插件