Ueda Shigeo, Sasaki Nobuhiro, Fukuda Miyuki, Hoshimaru Minoru
Shin-Aikai Spine Center, Katano Hospital, Katano City, Osaka, Japan.
Case Rep Orthop. 2016;2016:8634831. doi: 10.1155/2016/8634831. Epub 2016 Oct 5.
Occipital condyle fractures (OCFs) have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT) and magnetic resonance imaging (MRI). The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.
枕髁骨折(OCFs)一直被视为罕见的创伤性损伤,但由于计算机断层扫描(CT)和磁共振成像(MRI)的普及,报告的OCFs数量逐渐增加。本报告中的患者表现为枕髁骨折和C1脱位,伴有创伤性小脑出血,导致颅颈交界区不稳定。该病例也是一种极为罕见的临床情况,患者因枕髁骨折继发创伤性下颅神经麻痹。患者转至我院时,由于小脑出血的手术治疗,枕骨仍存在广泛缺损。因此,为了牢固固定枕骨板,同时进行了树脂颅骨成形术。使用树脂制成的枕骨固定钛板和螺钉,使我们能够进行颅颈交界区的后路融合。尽管患者术后佩戴头环背心3个月,但术后包括颈部疼痛以及咽喉和喉部麻痹在内的下颅神经症状有所改善。术后门诊随访5年期间未发现并发症。