Padwal A, Shukla D, Bhat D I, Somanna S, Devi B I
Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
J Clin Neurosci. 2016 Jun;28:61-6. doi: 10.1016/j.jocn.2015.05.074. Epub 2016 Feb 26.
Post-traumatic cervical spondyloptosis is a rare condition associated with high energy injuries, and to our knowledge only case reports are available. There are no universally accepted treatment paradigms for these cases and management is individualised according to the case and surgeon preference. We retrospectively analysed our management and clinical outcomes of this condition. From January 2007 to August 2014 we treated eight patients with cervical spondyloptosis at our institute. Only two patients had no neurological deficits; all the remaining patients had partial cord injury. Seven were treated surgically with preoperative traction followed by anterior cervical discectomy and fusion with fixation in three patients, and combined anterior and posterior fusion and fixation in four. Depending on the presence of anterior compression by a disc an anterior first or posterior first approach was advocated. All four combined anterior and posterior fusion and fixation patients needed to be turned more than once (540°). There was no neurological deterioration in any of the patients, as they either improved or remained stable neurologically. Post-traumatic cervical spondyloptosis is a challenging entity to manage. Surgery can be done safely with good clinical and radiological outcome and needs to be tailored to the individual patient.
创伤后颈椎椎体滑脱是一种与高能量损伤相关的罕见病症,据我们所知,仅有病例报告。对于这些病例,尚无普遍接受的治疗模式,治疗需根据具体病例和外科医生的偏好进行个体化处理。我们回顾性分析了我们对这种病症的治疗及临床结果。2007年1月至2014年8月,我们在本机构治疗了8例颈椎椎体滑脱患者。只有2例患者没有神经功能缺损;其余所有患者均有部分脊髓损伤。7例接受了手术治疗,术前进行牵引,3例患者随后行颈椎前路椎间盘切除融合内固定术,4例患者行前后联合融合内固定术。根据椎间盘是否存在前方压迫,提倡采用前路优先或后路优先的手术入路。所有4例行前后联合融合内固定术的患者均需要翻身超过一次(540°)。所有患者均未出现神经功能恶化,神经功能均有所改善或保持稳定。创伤后颈椎椎体滑脱是一种具有挑战性的病症。手术可以安全进行,临床和影像学效果良好,且需要根据个体患者进行调整。