Loret Jean-Edouard, Francois Patrick, Papagiannaki Chrysanthi, Cottier Jean-Philippe, Terrier Louis-Marie, Zemmoura Ilyess
Service de Neurochirurgie, CHU de Tours, Tours, France.
Eur J Orthop Surg Traumatol. 2013 Jul;23 Suppl 1:S107-10. doi: 10.1007/s00590-013-1228-8. Epub 2013 Jun 1.
We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension.
我们报告了一例41岁女性患者，该患者通过右侧前路入路在C4C5和C5C6节段进行了颈椎全椎间盘置换术，并在C6C7节段进行了融合术。麻醉恢复后，患者因右侧大脑半球大面积中风出现左侧偏瘫和面瘫。患者一旦出现中风的神经症状，即刻进行了扩散加权磁共振成像检查，结果显示右侧颈内动脉夹层。随后进行了数字减影血管造影、血管内支架置入、血管成形术和血栓切除术。治疗6个月后，临床检查显示左臂轻度痉挛。据我们所知，仅报告了两例无夹层或血栓形成的颈内动脉中风病例。总之，尽管颈椎前路手术后血管并发症罕见，但仍可能发生颈内动脉夹层。疑似危险因素为颈动脉长时间牵拉和颈部伸展。
