Mac Millan M, Stauffer E S
Department of Orthopaedic Surgery, University of Florida College of Medicine, Gainesville 32610.
J Spinal Disord. 1991 Dec;4(4):449-54. doi: 10.1097/00002517-199112000-00007.
The effect of fused segments in the cervical spine has been documented to cause chronic changes in adjacent levels. This article reports an association between the presence of fused cervical segments and the predisposition to acute, traumatic instability at adjacent levels. Patients with cervical fractures were reviewed during a 12-year period. Fifteen patients were identified who sustained cervical fractures in the presence of previously fused segments. The presence of fusion was reviewed for its effect of neurologic injury, delay in diagnosis, and patterns of fractures. The diagnostic studies used to document instability were reviewed. We found that preexisting cervical fusions often result in a delay of diagnosis because of altered anatomy and atypical fracture patterns. The fractures occurred within one or two levels from the fused segment. There are different fracture patterns associated with fusions in the upper cervical spine and those fusions in the lower cervical spine. The presence of fusions significantly affected treatment choices in this group of patients.
颈椎融合节段的影响已被证实会导致相邻节段发生慢性改变。本文报告了颈椎融合节段的存在与相邻节段急性创伤性不稳定倾向之间的关联。对12年间的颈椎骨折患者进行了回顾性研究。确定了15例在先前存在融合节段的情况下发生颈椎骨折的患者。评估了融合的存在对神经损伤、诊断延迟和骨折类型的影响。回顾了用于记录不稳定情况的诊断研究。我们发现，由于解剖结构改变和非典型骨折类型，先前存在的颈椎融合常常导致诊断延迟。骨折发生在距融合节段一或两个节段范围内。上颈椎融合和下颈椎融合存在不同的骨折类型。融合的存在显著影响了这组患者的治疗选择。
