Takamatsu Ryo, Takahashi Hiroshi, Yokoyama Yuichiro, Terajima Fumiaki, Inoue Yasuhiro, Fukutake Katsunori, Wada Akihito
Department of Orthopaedic Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan.
Case Rep Orthop. 2013;2013:421087. doi: 10.1155/2013/421087. Epub 2013 Apr 2.
We report a case of delayed myelopathy caused by atlantoaxial subluxation without fracture. The patient was a 38-year-old male who became aware of weakness in extremities. The patient had a history of hitting his head severely while diving into a swimming pool at the age of 14 years old. At that time, cervical spine plain X-ray images showed no fracture, and the cervical pain disappeared after use of a collar for several weeks. At his first visit to our department, X-ray images showed an unstable atlantoaxial joint. After surgery, weakness of the extremities gradually improved. At 6 months after surgery, bone union was completed and the symptoms disappeared. This case shows that atlantoaxial ligament injuries are difficult to diagnose and may easily be missed. A high level of suspicion is important in such cases, since neurological compromise or deterioration may occur many years after the injury.
我们报告一例由无骨折的寰枢椎半脱位引起的迟发性脊髓病。患者为一名38岁男性，自觉四肢无力。患者有14岁时跳入游泳池时头部严重撞击的病史。当时，颈椎X线平片未显示骨折，使用颈托数周后颈部疼痛消失。首次就诊时，X线片显示寰枢关节不稳定。手术后，四肢无力逐渐改善。术后6个月，骨愈合完成，症状消失。该病例表明，寰枢椎韧带损伤难以诊断，可能容易漏诊。在此类病例中高度怀疑很重要，因为损伤多年后可能会出现神经功能损害或恶化。
