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切开复位及短节段融合治疗创伤性单侧L3-4小关节脱位

Traumatic Unilateral L3-4 Jumped Facet Treated with Open Reduction and Short Segment Fusion.

作者信息

Rhea Evan, Rahmathulla Gazanfar

机构信息

Department of Orthopedic Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA.

Department of Neurological Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA.

出版信息

World Neurosurg. 2018 Nov;119:103-107. doi: 10.1016/j.wneu.2018.07.199. Epub 2018 Jul 31.

Abstract

BACKGROUND

Facet dislocations, or jumped facets, are part of a spectrum of flexion-distraction spine injuries. Bilateral and unilateral facet dislocations are commonly seen in the cervical spine. Traumatic jumped facets in the lumbar spine are rare injuries, and most involve the lumbosacral junction. Lumbar facet subluxations occur commonly in young patients owing to flexion-distraction forces on the lumbar spine at the time of injury combined with ligamentous laxity that exists in young patients.

CASE DESCRIPTION

A 24-year-old man presented with a unilateral right facet dislocation at L3-4 with anterolisthesis and canal stenosis after a motor vehicle accident.

CONCLUSIONS

Following anatomic reduction, unilateral jumped facets can be effectively treated with instrumented stabilization. This report provides evidence for the durability of short segment arthrodesis in select cases of a rare lumbar facet subluxation.

摘要

背景

小关节脱位,或称为关节突跳跃,是屈曲-牵张型脊柱损伤的一部分。双侧和单侧小关节脱位常见于颈椎。腰椎创伤性关节突跳跃是罕见的损伤,且大多数累及腰骶交界处。腰椎小关节半脱位在年轻患者中很常见,这是由于受伤时腰椎受到的屈曲-牵张力,再加上年轻患者存在的韧带松弛。

病例描述

一名24岁男性在机动车事故后出现L3-4右侧单侧小关节脱位并伴有椎体前滑脱和椎管狭窄。

结论

解剖复位后,单侧关节突跳跃可通过器械固定有效治疗。本报告为罕见的腰椎小关节半脱位特定病例中短节段融合术的持久性提供了证据。

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