Robichaud Aaron S, Barry Tricia K, Barry Sean P
Division of Neurosurgery, Dalhousie University, Division of Neurosurgery, Halifax Infirmary, 1796 Summer Street, Halifax, NS, Canada, B3H 3A7.
Epilepsy Behav Rep. 2019 Dec 20;13:100352. doi: 10.1016/j.ebr.2019.100352. eCollection 2020.
While rare, post-ictal thoracolumbar burst fractures are commonly missed due to confounding factors, resulting in delayed treatment and the potential for serious neurological deficits. This paper serves as a call for a high-degree of clinical suspicion when treating post-ictal patients to ensure they undergo a focused neurological examination of the lower extremities. If unresponsive/uncooperative, spinal precautions should be maintained until the spine can be cleared clinically or radiographically. In all events, if the patient is complaining of musculoskeletal pain possibly originating from the spine, radiographic evaluations are warranted to prevent possible deficits caused by a missed thoracolumbar fracture.
虽然罕见,但发作后胸腰椎爆裂骨折常因混杂因素而被漏诊,导致治疗延迟以及出现严重神经功能缺损的可能性。本文旨在呼吁在治疗发作后的患者时保持高度的临床怀疑,以确保对其下肢进行重点神经系统检查。如果患者无反应/不配合,应采取脊柱防护措施,直至通过临床或影像学检查排除脊柱问题。在任何情况下,如果患者主诉可能源于脊柱的肌肉骨骼疼痛,都有必要进行影像学评估,以防止因漏诊胸腰椎骨折而可能导致的功能缺损。