Mochidome Mariko, Sakamoto Akiyuki, Tanaka Hidenori, Sugiyama Daisuke, Kawamata Mikito
Department of Anesthesiology & Resuscitology, Shinshu University School of Medicine, Matsumoto 390-0802.
Masui. 2013 Apr;62(4):462-5.
There are only a few reports on cesarean section in a patient with cervical fracture without spinal cord injury (SCI). Such patients have high risks for deterioration of SCI following general or regional anesthesia. Here, we present a patient with a fracture of C2 vertebra who underwent cesarean section safely under combined spinal and epidural anesthesia(CSEA). A 30-year-old woman had a fracture of the C2 cervical vertebra (Hangman's fracture) due to a traffic accident at 34 weeks of gestation. Conservative immobilization of the head and neck was done with a neck collar (Philadelphia brace) in order to prevent subsequent SCI after the spine injury. Pre-viability amniorrhexis was seen at 37 weeks' gestation, and an emergency cesarean section was scheduled under combined epidural and spinal anesthesia (CSEA). Her neck and head were carefully fixed before, during and after surgery in order to prevent subsequent SCI. As a result, cesarean section under CSEA was successfully performed in the patient without any deterioration of the spine and/or SCI.
关于无脊髓损伤（SCI）的颈椎骨折患者剖宫产的报道仅有少数几例。此类患者在全身麻醉或区域麻醉后发生SCI恶化的风险很高。在此，我们报告一例C2椎体骨折患者，其在腰麻-硬膜外联合麻醉（CSEA）下安全地接受了剖宫产手术。一名30岁女性在妊娠34周时因交通事故导致C2颈椎骨折（绞刑架骨折）。为防止脊柱损伤后发生继发性SCI，使用颈托（费城颈托）对头颈部进行了保守固定。妊娠37周时出现胎膜早破，计划在硬膜外和腰麻联合麻醉（CSEA）下进行急诊剖宫产。手术前、手术中和手术后都小心地固定她的颈部和头部，以防止继发性SCI。结果，该患者在CSEA下成功进行了剖宫产，脊柱和/或SCI未出现任何恶化。
