Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland.
J Neurosurg Spine. 2010 Jul;13(1):17-23. doi: 10.3171/2010.3.SPINE09610.
Cervical spondylolysis is an uncommon disorder involving a cleft at the pars interarticularis. It is most often found at the C-6 level, and clinical presentations have included incidental radiographic findings, neck pain, and rarely neurological compromise. Although subaxial cervical spondylolysis has been described in 150 patients, defects at the C-2 pedicles are rare. The authors present 2 new cases of C-2 spondylolysis in athletically active young persons who did not demonstrate instability or neurological deficits, were able to remain active, and are being managed conservatively with serial examinations and imaging. They also discuss the results of 22 previously reported cases of C-2 spondylolysis. Based on the literature and their own experience, the authors conclude that most patients with C-2 spondylolysis remain neurologically intact, maintain stability despite the bony defect, and can be managed conservatively. Surgery is reserved for patients who demonstrate severe instability or spinal cord compromise due to stenosis.
颈椎峡部裂是一种不常见的疾病，涉及关节突间的裂隙。它最常发生在 C6 水平，临床表现包括偶然的影像学发现、颈部疼痛，很少出现神经功能障碍。虽然在下颈椎段已经描述了 150 例颈椎峡部裂，但 C2 椎弓根的缺损很少见。作者报告了 2 例新的 C2 段脊椎裂病例，这些病例发生在运动活跃的年轻人中，他们没有表现出不稳定或神经功能缺损，能够保持活跃，并通过连续检查和影像学检查进行保守治疗。他们还讨论了 22 例以前报道的 C2 脊椎裂病例的结果。根据文献和他们自己的经验，作者得出结论，大多数 C2 脊椎裂患者保持神经完整，尽管存在骨缺损，但仍保持稳定，可以保守治疗。手术仅适用于因狭窄而出现严重不稳定或脊髓压迫的患者。
