Zwingenberger Stefan, Leimert Mario, Valladares Roberto D, Betz Volker M, Seifert Jens
Department of Orthopaedics, University Hospital Carl Gustav Carus at Technical University, Fetscherstraße 74, Dresden, D-01307, Germany.
J Med Case Rep. 2012 Jun 12;6:146. doi: 10.1186/1752-1947-6-146.
In contrast to spondylolisthesis of the lumbar spine, non-traumatic cervico-thoracic spondylolisthesis is a very rare lesion. Even minor changes in the displacement of the vertebrae or the cord can lead to cervical myelopathy and paralysis. Since only a few cases have been well-documented, there is currently no clear preference between operative techniques.
We describe the case of a 63-year-old Caucasian man with a 13 mm spondylolisthesis between C7 and T1. Within a few months, a progressive cervical myelopathy developed as he began to suffer pain and loss of function of his digits and was no longer able to walk unassisted. In an interdisciplinary collaboration between neurological and orthopedic surgeons, a ventral-dorsal-ventral approach was performed on one vertebral section. The ventral removal of the intervertebral disc was followed by laminectomy and dorsal instrumentation. A new application technique was established by inserting bicortical screws into the transverse processes of T2 and T3. The structure was subsequently stabilized by the ventral insertion of a Harms basket. The procedure was successful as it halted progression of the myelopathy. The patient demonstrated improved sensitivity and recovered the ability to walk unassisted. He has now been able to walk unassisted for two years postoperatively.
This paper describes a successful treatment for a very rare case of cervico-thoracic spondylolisthesis. The technique of inserting bicortical screws into the transverse processes is a fast, safe and successful method that does not require the use of intraoperative radiographs for placement of the bicortical screws into the transverse processes.
与腰椎滑脱症不同，非创伤性颈胸段椎体滑脱是一种非常罕见的病变。即使椎体或脊髓移位的微小变化也可能导致颈椎病和瘫痪。由于仅有少数病例有充分记录，目前手术技术之间尚无明确的偏好。
我们描述了一名63岁白种男性的病例，其C7和T1之间存在13毫米的椎体滑脱。在几个月内，随着他开始出现手指疼痛和功能丧失且无法独立行走，逐渐发展为进行性颈椎病。在神经外科医生和骨科医生的跨学科合作下，对一个椎体节段采用了前后腹侧入路。先进行椎间盘腹侧切除，然后进行椎板切除术和背侧内固定。通过将双皮质螺钉插入T2和T3的横突建立了一种新的应用技术。随后通过腹侧插入哈姆斯笼来稳定结构。该手术成功地阻止了脊髓病的进展。患者的感觉有所改善，并恢复了独立行走的能力。术后两年他现在已经能够独立行走。
本文描述了对一例非常罕见的颈胸段椎体滑脱病例的成功治疗。将双皮质螺钉插入横突的技术是一种快速、安全且成功的方法，在将双皮质螺钉插入横突时无需使用术中X线片。
