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胸腰段交界处完全性创伤性椎体滑脱的确定性单阶段后路手术矫正。

Definitive single-stage posterior surgical correction of complete traumatic spondyloptosis at the thoracolumbar junction.

作者信息

Sandquist Lee, Paris Alexander, Fahim Daniel K

机构信息

Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.

出版信息

J Neurosurg Spine. 2015 Jun;22(6):653-7. doi: 10.3171/2014.10.SPINE14165. Epub 2015 Mar 20.

Abstract

Complete dislocation at the thoracolumbar junction is a rare occurrence, with only 4 previously reported cases in 3 separate series. Surgical procedures in the reported cases of spondyloptosis at the thoracolumbar junction have been described using instrumentation, reduction, decompression, and stabilization techniques. In this report the authors' patient presented with spondyloptosis at the thoracolumbar junction, resulting in a T-11 American Spinal Injury Association Grade A injury. The authors corrected the patient's thoracolumbar spondyloptosis with surgical reconstruction without the use of leveraged instrumented reduction. They describe a single-stage, posterior-only spinal realignment, reconstruction, and stabilization. Within months of beginning postoperative therapy, the patient enrolled and attended courses at a local college and regained personal independence by learning to drive a motor vehicle with a hand control. Two-year radiographic and clinical follow-up confirms solid fusion across the reconstruction.

摘要

胸腰段交界处的完全脱位很少见,在3个不同系列中此前仅报道过4例。已描述了胸腰段交界处脊柱滑脱症报告病例中的手术方法,包括器械辅助、复位、减压和稳定技术。在本报告中,作者的患者表现为胸腰段交界处脊柱滑脱,导致美国脊髓损伤协会(ASIA)分级为A级的T-11损伤。作者在不使用杠杆器械辅助复位的情况下,通过手术重建矫正了患者的胸腰椎脊柱滑脱。他们描述了一种单阶段、仅后路的脊柱重新排列、重建和稳定手术。术后治疗开始后的几个月内,患者注册并参加了当地一所大学的课程,并通过学习驾驶配备手动控制装置的机动车重新获得了个人独立。两年的影像学和临床随访证实重建部位实现了牢固融合。

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