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隐性脊柱裂伴寰椎发育不全的枢椎板内陷性异常引起的颈髓病变:病例报告。

A cervical myelopathy caused by invaginated anomaly of laminae of the axis in spina bifida occulta with hypoplasia of the atlas: case report.

机构信息

Department of Orthopaedics, Changzheng Hospital, No. 415 Fengyang Road, Huangpu, Shanghai, China.

出版信息

Spine (Phila Pa 1976). 2010 Apr 20;35(9):E351-5. doi: 10.1097/BRS.0b013e3181cb467c.

Abstract

STUDY DESIGN

A case report and review of previous literature are presented.

OBJECTIVE

The objective of this manuscript was to report a case of cervical myelopathy caused by invaginated anomalous laminae of the axis in a spina bifida occulta patient with hypoplasia of the arch of the atlas and to discuss the etiology of this disease.

SUMMARY OF BACKGROUND DATA

To the authors' knowledge, few cases of cervical myelopathy due to invaginated anomalous laminae of the axis have been reported, none of which is combined with hypoplasia of the arch of atlas. Treatment was surgical removal of the invaginated laminae.

METHODS

The patient's history, clinical examination, imaging findings, and treatment were reported, and the etiology was discussed.

RESULTS

Characteristic findings were revealed from imaging studies and multiplane reconstruction of the computed tomography images. The patient was treated with a posterior decompressive operation based on the images. A rapid improvement was observed after the surgery, and the patient's neurology was completely restored 1 month later.

CONCLUSION

We reported a rare characteristic anomaly of the laminae of the axis with hypoplasia of the posterior arch of atlas. A multiplane reconstruction of the computed tomography images was very necessary for treatment of this case. Possible causes of this anomaly may be the failure of ossification or fusion of the embryological term, whereas invagination of the osteophyte may be associated with the traction of the dense fibrous band during growth and development. Surgical removal of the laminae could result in a satisfactory outcome.

摘要

研究设计

报告了 1 例病例,并对以往文献进行了回顾。

目的

本研究旨在报告 1 例隐性脊柱裂患者因寰椎弓发育不全伴轴突内陷异常椎板引起的颈脊髓病,并讨论该病的病因。

背景资料总结

据作者所知,很少有因轴突内陷异常椎板引起的颈脊髓病病例报告,且均无合并寰椎弓发育不全。治疗方法为手术切除内陷的椎板。

方法

报告了患者的病史、临床检查、影像学表现和治疗情况,并讨论了病因。

结果

影像学研究和 CT 多平面重建显示出特征性表现。根据影像学表现,患者接受了后路减压手术。术后患者迅速好转,1 个月后神经功能完全恢复。

结论

我们报告了一种罕见的伴有寰椎后弓发育不全的轴突异常,CT 多平面重建对治疗该病例非常必要。这种异常的可能原因是胚胎期骨化或融合失败,而骨赘的内陷可能与生长发育过程中致密纤维带的牵引有关。椎板切除术可获得满意的结果。

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