Miekisiak Grzegorz
Department of Neurosurgery, Specialist Medical Center, Polanica-Zdroj, Poland.
J Craniovertebr Junction Spine. 2015 Apr-Jun;6(2):86-8. doi: 10.4103/0974-8237.156070.
Pure ligamentous flexion-distraction injuries of the lumbar spine are relatively rare and even less commonly associated with neurologic compromise. They are largely related to the use of lap belt restrains during motor vehicle accidents. We report a 19-year-old female backseat passenger wearing a lap belt who was involved in a head-on collision. On admission she was paraplegic, with a T12 sensory level and no motor and sensory function of S4-S5 (American Spinal Injury Association (ASIA) A). Plain X-ray and computerized axial tomography (CAT) spine showed a flexion-distraction injury at the L3-L4 level. During surgery in the interspinous space a conus medullaris was identified, which was completely severed from the spinal cord. The patient underwent a fusion procedure and made a good recovery. Twelve months after surgery she was able to walk with a knee-ankle-foot orthosis, she has no motor function below knees, no sensation below L2, and no voluntary bladder control. Although described type of injury is very rare, one should always have in mind devastating consequences of inadequate or improperly worn seatbelts.
腰椎单纯韧带性屈伸牵张损伤相对少见，与神经功能损害相关的情况则更为罕见。它们主要与机动车事故中安全带的使用有关。我们报告一名19岁女性后座乘客，她系着安全带，遭遇了正面碰撞。入院时她截瘫，感觉平面在T12，S4 - S5无运动和感觉功能（美国脊髓损伤协会（ASIA）A级）。脊柱平片和计算机断层扫描（CAT）显示L3 - L4水平有屈伸牵张损伤。手术中在棘突间间隙发现圆锥马尾，它与脊髓完全离断。患者接受了融合手术，恢复良好。术后12个月，她能够借助膝踝足矫形器行走，膝以下无运动功能，L2以下无感觉，无自主膀胱控制。尽管所述类型的损伤非常罕见，但人们应始终牢记安全带使用不当或佩戴不合适所带来的灾难性后果。
