Grannis Gordon H, Hoang Kenneth Q
Grannis Chiropractic Clinic, Aliso Viejo, California.
J Chiropr Med. 2019 Mar;18(1):48-55. doi: 10.1016/j.jcm.2018.07.007. Epub 2019 May 7.
The purpose of this study is to describe the evaluation and management of a surfer who presented with concussion-like symptoms and was eventually diagnosed with an unstable cervical spine fracture.
A young man presented to a chiropractic clinic 5 weeks after a surfing injury. He had mild lower cervical spine pain and complaints of cognitive disturbance. He was previously evaluated by his primary care provider who diagnosed cervical sprain and strain injuries. There was no prior imaging or follow-up concussion management.
After a history, exams were performed of the cervical spine, thoracic spine, shoulder, and head, including a modified Sport Concussion Assessment Tool, Third Edition, concussion evaluation. Cervical spine radiographs were taken, which demonstrated a right C6 pillar fracture grade 2 anterior spondylolisthesis. These findings were confirmed with a CT scan. The patient was referred to an orthopedic spine specialist for further consultation, which resulted in cervical fusion of the C6/7 motor unit.
The use of clinical guidelines for head and neck injury assisted in the appropriate management of this patient with cervical spine injury presenting with concussion symptoms.
本研究旨在描述一名出现类似脑震荡症状并最终被诊断为颈椎不稳定骨折的冲浪者的评估与管理过程。
一名年轻男子在冲浪受伤5周后前往一家整脊诊所就诊。他有轻度下颈椎疼痛,并伴有认知障碍主诉。他之前由其初级保健医生进行过评估,被诊断为颈椎扭伤和拉伤。此前未进行过影像学检查或后续的脑震荡管理。
在了解病史后,对颈椎、胸椎、肩部和头部进行了检查,包括使用改良的第三版运动性脑震荡评估工具进行脑震荡评估。拍摄了颈椎X光片,显示右侧C6椎弓根骨折伴2级前滑脱。CT扫描证实了这些发现。该患者被转介给脊柱骨科专家进行进一步会诊,最终对C6/7运动单元进行了颈椎融合手术。
使用头颈部损伤临床指南有助于对头颈部损伤伴脑震荡症状的该患者进行适当管理。