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1例在新型冠状病毒肺炎大流行期间漏诊的不稳定型颈椎损伤病例。

A case of missed unstable cervical injury during the COVID-19 pandemic.

作者信息

Archer James E, Gardner Adrian

机构信息

Spinal Surgery Department, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.

出版信息

J Surg Case Rep. 2020 Sep 10;2020(9):rjaa293. doi: 10.1093/jscr/rjaa293. eCollection 2020 Sep.

DOI:10.1093/jscr/rjaa293
PMID:32939243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7482958/
Abstract

This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings and the subsequent management of the injury. The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine.

摘要

本病例报告讨论了一名患有严重、不稳定的颈椎三柱损伤的患者，该损伤最初未被检测到，在受伤后2周的重新评估中才被发现。报告讨论了影像学检查结果以及该损伤的后续治疗。报告强调了对每个病例进行个体化评估的必要性，要考虑到受伤情况以及脊柱中任何先前存在的退行性改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/4d5e403ee030/rjaa293f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/b9f65ce71f30/rjaa293f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/bb19bce3bcbb/rjaa293f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/a69616ef3d42/rjaa293f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/ec25ffc0f52e/rjaa293f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/4d5e403ee030/rjaa293f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/b9f65ce71f30/rjaa293f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/bb19bce3bcbb/rjaa293f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/a69616ef3d42/rjaa293f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/ec25ffc0f52e/rjaa293f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb0/7482958/4d5e403ee030/rjaa293f5.jpg

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本文引用的文献

1
The Unstable Spine: A Surgeon's Perspective.
Semin Ultrasound CT MR. 2018 Dec;39(6):618-629. doi: 10.1053/j.sult.2018.10.001. Epub 2018 Oct 13.
2
Cervical spine clearance in adults following blunt trauma: a national survey across major trauma centres in England.钝性创伤后成人颈椎的评估：英格兰主要创伤中心的全国性调查
Clin Radiol. 2018 Apr;73(4):410.e1-410.e8. doi: 10.1016/j.crad.2017.11.006. Epub 2017 Dec 8.
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Fractures in Spinal Ankylosing Disorders: A Narrative Review of Disease and Injury Types, Treatment Techniques, and Outcomes.脊柱强直性疾病中的骨折：疾病与损伤类型、治疗技术及结果的叙述性综述
J Orthop Trauma. 2017 Sep;31 Suppl 4:S57-S74. doi: 10.1097/BOT.0000000000000953.
4
Traumatic subaxial cervical facet subluxation and dislocation: epidemiology, radiographic analyses, and risk factors for spinal cord injury.创伤性下颈椎关节突关节半脱位和脱位：流行病学、影像学分析和脊髓损伤的危险因素。
Spine J. 2018 Mar;18(3):387-398. doi: 10.1016/j.spinee.2017.07.175. Epub 2017 Jul 21.
5
The impact of facet dislocation on clinical outcomes after cervical spinal cord injury: results of a multicenter North American prospective cohort study.颈椎脊髓损伤后路手术中关节突交锁对临床疗效的影响：一项多中心北美前瞻性队列研究结果。
Spine (Phila Pa 1976). 2013 Jan 15;38(2):97-103. doi: 10.1097/BRS.0b013e31826e2b91.
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Management of acute spinal fractures in ankylosing spondylitis.强直性脊柱炎急性脊柱骨折的管理
ISRN Rheumatol. 2011;2011:150484. doi: 10.5402/2011/150484. Epub 2011 Jun 30.
7
Anterior displacement correlates with neurological impairment in cervical facet dislocations.颈椎小关节脱位中的前脱位与神经功能损害相关。
Int Orthop. 2003;27(3):190-3. doi: 10.1007/s00264-003-0449-6. Epub 2003 Mar 26.
8
A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine.下颈椎闭合性间接骨折与脱位的机制分类
Spine (Phila Pa 1976). 1982 Jan-Feb;7(1):1-27. doi: 10.1097/00007632-198200710-00001.