Etgen Thorleif, Rieder Georg
Klinikum Traunstein, Department of Neurology, Cuno-Niggl-Str. 3, Traunstein, 83278, Germany.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.12.2008.1400. Epub 2009 May 21.
Cervical injury is a serious and often fatal complication of ankylosing spondylitis in the setting of minor trauma. This case report describes a 51-year-old woman with ankylosing spondylitis and a minor trauma who developed severe bradycardia during positioning for x ray. Further diagnostic revealed a hyperextensive fracture of C4 with fragments compressing the cervical medulla. The woman subsequently died from hypoxic brain damage. Reviewing the literature, a high alertness in ankylosing spondylitis and minor trauma with neck immobilisation is emphasised, early diagnosis using cervical spine computed tomography is essential to a favourable outcome, and the mechanism of bradycardia in cervical trauma is discussed.
颈椎损伤是强直性脊柱炎在轻微创伤情况下的一种严重且常致命的并发症。本病例报告描述了一名51岁患有强直性脊柱炎的女性，在接受X光定位时因轻微创伤而出现严重心动过缓。进一步诊断发现C4椎体过伸性骨折，骨折碎片压迫颈髓。该名女性随后因缺氧性脑损伤死亡。回顾文献，强调了对强直性脊柱炎和伴有颈部固定的轻微创伤需保持高度警惕，早期使用颈椎计算机断层扫描进行诊断对取得良好预后至关重要，并对颈椎创伤中心动过缓的机制进行了讨论。
