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创伤性寰枕关节脱位:儿童和青少年的预后比成人更好还是更差?一项叙述性综述。

Traumatic atlanto-occipital dislocation: do children and adolescents have better or worse outcomes than adults? A narrative review.

作者信息

Tubbs R Shane, Patel Chirag, Loukas Marios, Oskouian Rod J, Chapman Jens R

机构信息

Seattle Science Foundation, Seattle, WA, USA.

Department of Anatomical Sciences, St. George's University, St. George's, Grenada.

出版信息

Childs Nerv Syst. 2016 Aug;32(8):1387-92. doi: 10.1007/s00381-016-3118-y. Epub 2016 May 25.

Abstract

BACKGROUND

Traumatic atlanto-occipital dislocation is an uncommon, severely unstable pathology, which can lead to detrimental or even fatal neurological impairment. Specifically, children have consistently been reported to be more susceptible to this type of injury because of their disproportionately larger head, ligament laxity, and injury mechanisms. However, to date, rates of missed injury and outcomes including neurologic recovery of pediatric and adult populations following this insult have not been comparatively evaluated.

METHODS

Standard search engines were used to investigate outcomes of traumatic atlanto-occipital dislocation in children and adolescents compared to adults.

CONCLUSIONS

Based on case reports and small series from the literature, it seems that children and adolescents tend to have a better likelihood of survival with the possibility of long-term neurological complications. Comparatively, adults who suffer traumatic atlanto-occipital dislocation either succumb to their injuries or survive with very little if any neurological complications.

摘要

背景

创伤性寰枕关节脱位是一种罕见的、严重不稳定的病理情况,可导致有害甚至致命的神经功能损害。具体而言,一直有报道称儿童更容易受到这类损伤,原因是他们的头部相对较大、韧带松弛以及损伤机制。然而,迄今为止,尚未对儿童和成人在遭受这种损伤后的漏诊率以及包括神经恢复情况在内的预后进行比较评估。

方法

使用标准搜索引擎调查儿童和青少年与成人创伤性寰枕关节脱位的预后情况。

结论

根据文献中的病例报告和小样本系列研究,儿童和青少年似乎存活可能性更大,但可能会有长期神经并发症。相比之下,遭受创伤性寰枕关节脱位的成人要么因伤死亡,要么存活但几乎没有神经并发症。

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