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C6-C7椎体严重滑脱:一例罕见病例报告

Spondyloptosis of C6-C7: a rare case report.

作者信息

Chadha Manish, Singh Ajay-Pal, Singh Arun Pal

机构信息

Department of Orthopaedics, Guru Teg Bahadur Hospital, University College of Medical Sciences, University of Delhi, New Delhi 110095, India.

出版信息

Chin J Traumatol. 2010 Dec;13(6):377-9.

Abstract

A 35 years old female presented to us after falling from a height. She complained of a neck pain and a complete quadriplegia and was diagnosed as having spondyloptosis of the C6-C7. Skeletal traction was performed on her. CT scan showed fractures of the C5, C6, and C7 vertebral body. The patient underwent anterior approach partial corpectomy with anterior cervical locking plate and strut grafting from ipsilateral iliac crest. Intraoperatively it was found that the disc was completely ruptured and there was a dural tear and cerebrospinal fluid leak. Her postoperative period was complicated by cerebrospinal fluid collection and posterior instrumentation was not performed due to the poor general condition. She had no neural recovery at the last follow-up. Spondyloptosis is a severe and highly unstable injury with a three column ligamentous disruption and may be complicated, as in our case, with a dural tear. Management of these cases is fraught with complications, and prognosis for neural recovery is dismal.

摘要

一名35岁女性从高处坠落后来我院就诊。她主诉颈部疼痛及完全性四肢瘫痪,被诊断为C6 - C7椎体滑脱。对其进行了骨骼牵引。CT扫描显示C5、C6和C7椎体骨折。患者接受了前路部分椎体切除、前路颈椎锁定钢板固定及取自同侧髂嵴的支撑植骨术。术中发现椎间盘完全破裂,存在硬脊膜撕裂及脑脊液漏。她的术后出现脑脊液聚集并发症,且由于全身状况较差未进行后路内固定术。在最后一次随访时她没有神经功能恢复。椎体滑脱是一种严重且高度不稳定的损伤,伴有三柱韧带断裂,并且可能如我们的病例一样并发硬脊膜撕裂。这些病例的治疗充满并发症,神经恢复的预后很差。

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