Wong Albert Sii Hieng, Yu Denis Hee Youg
Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia.
Department of Orthopaedics, Timberland Medical Center, 93250 Kuching, Sarawak, Malaysia.
Asian J Neurosurg. 2015 Jan-Mar;10(1):53. doi: 10.4103/1793-5482.151519.
Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.
四肢瘫痪完全恢复在颈椎损伤中并不常见。对于强直性脊柱炎患者因颈椎骨折导致脊髓硬膜外血肿后完全恢复的情况，此前尚无报道。我们报告一例强直性脊柱炎患者颈椎骨折并伴有四肢瘫痪的病例。该患者接受了两阶段的固定和融合手术，最终完全康复。术后两小时，他在重症监护病房时四肢力量就已完全恢复。他后来重返全职工作岗位。文献中仅有另外两篇报道，分别是强直性脊柱炎合并硬膜外血肿的患者在12小时内接受治疗，最终分别从四肢轻瘫和截瘫中完全康复。强直性脊柱炎患者发生脊柱骨折和硬膜外血肿的几率更高。早期诊断和治疗可取得良好效果，这不仅能确保脊柱稳定，还能使四肢瘫痪患者迅速且完全康复。
