Alves Pedro Luz, Martins Delio Eulalio, Ueta Renato Hiroshi Salvioni, Del Curto David, Wajchenberg Marcelo, Puertas Eduardo Barros
Department of Orthopedics and Traumatology, Universidade Federal de Sao Paulo, Rua Borges Lagoa, 783, 5th floor, 04038-032, São Paulo, SP, Brazil.
J Med Case Rep. 2015 Oct 21;9:234. doi: 10.1186/s13256-015-0720-7.
The surgical treatment of unstable cervical fractures is challenging for spinal surgeons. Unstable cervical fractures associated with spondyloarthropathy and deformities that alter function, form and stability present a greater challenge. Having multiple options to manage this difficult situation is important to all spine surgeons and the results of each case depends on the singular characteristics of patients. The purpose of this case report is to describe the main forms of presentation of unstable cervical subaxial fractures in the spondylotic spine and their surgical treatments.
We present three cases of Caucasian men aged 30, 53 and 59 years with spondylosis with unstable cervical fractures and alternatives choices for surgical treatment, and a review of the literature. Each patient underwent a different surgical procedure of the cervical subaxial spine using an isolated anterior, posterior or combined approach demonstrating good outcomes in all cases.
The treatment of subaxial cervical spinal fractures is complex, and when these fractures are associated with the deformities caused by spondyloarthropathies they can be thought provoking for spine surgeons such as orthopedists or neurosurgeons. The isolated anterior, posterior and combined approaches are safe and effective for treating these pathologies.
不稳定型颈椎骨折的外科治疗对脊柱外科医生来说具有挑战性。与脊柱关节病相关且伴有改变功能、形态和稳定性的畸形的不稳定型颈椎骨折带来的挑战更大。拥有多种应对这一难题的选择对所有脊柱外科医生都很重要,而且每个病例的结果取决于患者的独特特征。本病例报告的目的是描述脊柱关节病性脊柱中不稳定型颈椎下颈椎骨折的主要表现形式及其外科治疗方法。
我们报告了三例年龄分别为30岁、53岁和59岁的白人男性病例,他们患有伴有不稳定型颈椎骨折的脊柱关节病以及外科治疗的替代选择,并对相关文献进行了综述。每位患者均采用单独的前路、后路或联合入路对颈椎下颈椎进行了不同的手术操作,所有病例均取得了良好的效果。
下颈椎骨折的治疗很复杂,当这些骨折与脊柱关节病引起的畸形相关时,对于骨科医生或神经外科医生等脊柱外科医生来说可能颇具挑战性。单独的前路、后路和联合入路治疗这些疾病是安全有效的。