Matshes Evan W, Joseph Jeffrey
University of Calgary, Department of Pathology & Laboratory Medicine, Calgary, AB, Canada.
J Forensic Sci. 2012 Jan;57(1):113-9. doi: 10.1111/j.1556-4029.2011.01935.x. Epub 2011 Oct 31.
When patients die after chiropractic or surgical interventions of the cervical spine, pathologists tasked with the autopsy are frequently overwhelmed by the complicated anatomy, laborious dissections, complex operative procedures and surgical hardware, and the necessity to differentiate artifacts from trauma and disease. However, abundant data can be obtained from careful evaluation of the cervical spine in situ; extensive postmortem diagnostic imaging procedures; detailed dissections of the removed, formalin-fixed and decalcified spine; and histology. This study presents a regimented, stepwise approach to the evaluation of the cervical spine in these difficult cases, promotes uniform assessment, facilitates diagnoses, and supports the accumulation of otherwise hard-to-come-by reference material that can be of value in future cases. The resultant detailed autopsy findings may prove useful in the medico-legal death investigation process. Autopsy findings may also be of great value to health care providers involved in quality assurance processes.
当患者在接受颈椎整脊或手术干预后死亡时，负责尸检的病理学家常常会被复杂的解剖结构、繁琐的解剖过程、复杂的手术操作和手术器械以及区分人为假象与创伤和疾病的必要性所困扰。然而，通过对原位颈椎进行仔细评估、广泛的死后诊断成像程序、对切除的经福尔马林固定和脱钙的脊柱进行详细解剖以及组织学检查，可以获得大量数据。本研究提出了一种在这些困难病例中评估颈椎的规范、逐步的方法，促进统一评估，便于诊断，并支持积累在未来病例中可能有价值的难以获得的参考资料。由此产生的详细尸检结果可能在法医学死亡调查过程中有用。尸检结果对于参与质量保证过程的医疗保健提供者也可能具有很大价值。
