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妊娠中期胸椎骨折脱位:病例报告及文献复习

FRACTURE-DISLOCATION OF THE THORACIC SPINE DURING SECOND TRIMESTER OF PREGNANCY: CASE REPORT AND LITERATURE REVIEW.

作者信息

Gotfryd Alberto Ofenhejm, Franzin Fernando José, Poletto Patricia Rios, Neto Nicola Jorge Carneiro, Júnior Roberto César Nogueira, Júnior Luiz Carlos Lopes Ferreira

机构信息

PhD. Chief Physician of the Spinal Disorders Group, Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.

Attending Physician in the Spinal Disorders Group, Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.

出版信息

Rev Bras Ortop. 2015 Dec 8;47(4):521-5. doi: 10.1016/S2255-4971(15)30140-3. eCollection 2012 Jul-Aug.

Abstract

Spinal fractures associated with spinal cord injury rarely affect pregnant patients. The authors present the case of a 20-year-old woman in her 20(th) week of pregnancy, who suffered fracture-dislocation of the thoracic spine (T4-T5) and underwent decompression, reduction and posterior fusion with pedicle screws. Despite the complete spinal cord injury presented, the pregnancy progressed uneventfully and resulted in birth via normal delivery of a healthy newborn at term. Some particular features of this case, like the care needed in using ionizing radiation, the surgical approach and delivery, use of steroids and pregnancy complications in such patients are discussed here. Only a multidisciplinary team composed by physicians from different specialties (spinal surgeons, obstetricians and physiatrists), nurses and physiotherapists is capable of assisting pregnant patients with spinal cord injuries satisfactorily.

摘要

与脊髓损伤相关的脊柱骨折很少影响孕妇。作者报告了一例20岁处于孕20周的女性病例,该患者发生了胸椎(T4-T5)骨折脱位,并接受了减压、复位及椎弓根螺钉后路融合术。尽管存在完全性脊髓损伤,但妊娠过程顺利,足月时通过正常分娩产下一名健康新生儿。本文讨论了该病例的一些特殊情况,如使用电离辐射时所需的注意事项、手术方式及分娩方式、类固醇的使用以及此类患者的妊娠并发症。只有由不同专业的医生(脊柱外科医生、产科医生和物理治疗师)、护士和物理治疗师组成的多学科团队才能令人满意地协助脊髓损伤的孕妇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4405/4799457/c83280ac5629/gr1.jpg

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