Mata-Gómez Jacinto, Ortega-Martínez Marta, Valencia-Anguita Julio, Gilete-Tejero Ignacio, Royano-Sánchez Manuel
Department of Neurosurgery, Hospital San Pedro de Alcántara, Av. Pablo Naranjo s/n. 10003 Cáceres, Spain.
Department of Neurosurgery. Virgen del Rocio University Hospital, C/Manuel Siurot s/n. 41006 Seville, Spain.
J Spine Surg. 2017 Mar;3(1):82-86. doi: 10.21037/jss.2017.02.10.
Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment. An anterior-posterior approach was performed to achieve a correct spinal fusion. After 18 months of follow-up care, the patient's symptoms improved significantly and she began to lead a normal life again. The case underlines the importance of performing a correct initial diagnostic workup upon a patient. This would improve surgical management by avoiding a worsening of the initial neurological deficit during the realignment maneuvers in the chronic grade III, IV or V spondylolisthesis.
创伤性颈椎严重滑脱是一种罕见且严重的病变,通常与脊髓损伤相关。然而,它偶尔会有症状轻微的病程,这可能会延迟其诊断。作者报告了一例特殊病例,一名33岁女性在交通事故9个月后出现下肢轻度痉挛和颈部疼痛。计算机断层扫描和磁共振成像显示C7-T1 III度滑脱和脊髓信号改变。最初的颈椎牵引未能实现脊柱复位。采用前后路联合手术实现了正确的脊柱融合。经过18个月的随访,患者症状明显改善,再次开始正常生活。该病例强调了对患者进行正确的初始诊断检查的重要性。这将通过避免在慢性III度、IV度或V度滑脱的复位操作过程中初始神经功能缺损的恶化来改善手术管理。