Yunoki Masatoshi, Kanda Takahiro, Suzuki Kenta, Uneda Atsuhito, Hirashita Koji, Yoshino Kimihiro
Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan.
Asian J Neurosurg. 2018 Jul-Sep;13(3):870-872. doi: 10.4103/ajns.AJNS_348_16.
A case of delayed occurrence of C3 vertebra anterior subluxation diagnosed 10 days after surgery for epidural hematoma is herein described. A 56-year-old man underwent surgery for right epidural hematoma. No spinal fracture was identified on the cervical-spinal computed tomography (CT) on arrival. The patient developed neck pain after the craniotomy, and cervical magnetic resonance imaging 5 days postoperatively revealed a disruption of the C3-C4 posterior ligament complex. The patient was conservatively treated with immobilization. Cervical CT 10 days postoperatively revealed C3 vertebra anterior subluxation. Posterior fixation surgery was performed 21 days after admission, and the postoperative course was uneventful. This case suggests that awareness of delayed occurrence of cervical dislocation after traumatic intracranial hemorrhage should be increased among neurosurgeons.
本文描述了1例硬膜外血肿手术后10天诊断为C3椎体前半脱位的病例。一名56岁男性接受了右侧硬膜外血肿手术。入院时颈椎计算机断层扫描（CT）未发现脊柱骨折。患者开颅术后出现颈部疼痛，术后5天颈椎磁共振成像显示C3-C4后韧带复合体断裂。患者接受了固定保守治疗。术后10天颈椎CT显示C3椎体前半脱位。入院21天后进行了后路固定手术，术后过程顺利。该病例提示神经外科医生应提高对创伤性颅内出血后颈椎脱位延迟发生的认识。
