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一名患有多发性上颈椎骨折、帕金森病和斜颈患者的急性脊髓挫伤：手术治疗

Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson's Disease, and Torticollis: Surgical Management.

作者信息

Merrill Sarah, Kalani Maziyar A, Patel Naresh P, Lyons Mark K, Neal Matthew T

机构信息

Mayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.

出版信息

Case Rep Orthop. 2020 Sep 11;2020:8897071. doi: 10.1155/2020/8897071. eCollection 2020.

DOI:10.1155/2020/8897071
PMID:32963863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7502122/
Abstract

. Spine surgery in patients with Parkinson's disease (PD) involves increased risk. We describe a case of cervical myelopathy in a patient with PD, multiple fractures involving the atlas and axis vertebrae, and spasmodic torticollis. The patient was successfully treated with an upper cervical decompression and occipital-cervical (OC) fusion surgery. Strategies for torticollis reduction and successful surgical outcome are discussed. Risks and benefits must be carefully weighed when considering occipital cervical fusion in PD patients. . Intraoperative manual reduction of laterocollis is possible after general endotracheal anesthesia, and continuous neuromonitoring is established. Use of optimizing strategies such as perioperative botulinum injections and intraoperative O-arm navigation should be considered.

摘要

帕金森病（PD）患者进行脊柱手术风险会增加。我们描述了一例患有PD、寰椎和枢椎多处骨折以及痉挛性斜颈的患者发生颈髓病的病例。该患者通过上颈椎减压和枕颈（OC）融合手术获得成功治疗。文中讨论了减少斜颈的策略和成功的手术结果。在考虑对PD患者进行枕颈融合时，必须仔细权衡风险和益处。在全身气管内麻醉后，术中可手动复位侧方斜颈，并建立连续神经监测。应考虑采用围手术期肉毒杆菌素注射和术中O型臂导航等优化策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/eea95b7d0b60/CRIOR2020-8897071.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/8ff23df1ad99/CRIOR2020-8897071.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/2367bb290d01/CRIOR2020-8897071.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/cd2b28024cdb/CRIOR2020-8897071.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/ab8c27b62874/CRIOR2020-8897071.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/523b837514d8/CRIOR2020-8897071.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/eea95b7d0b60/CRIOR2020-8897071.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/8ff23df1ad99/CRIOR2020-8897071.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/2367bb290d01/CRIOR2020-8897071.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/cd2b28024cdb/CRIOR2020-8897071.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/ab8c27b62874/CRIOR2020-8897071.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/523b837514d8/CRIOR2020-8897071.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10e/7502122/eea95b7d0b60/CRIOR2020-8897071.006.jpg

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本文引用的文献

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World Neurosurg. 2019 Dec;132:e463-e471. doi: 10.1016/j.wneu.2019.08.114. Epub 2019 Aug 27.
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Etiology and Management of Spinal Deformity in Patients With Parkinson's Disease.帕金森病患者脊柱畸形的病因与管理
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3
Accuracy of Screw Placement and Clinical Outcomes After O-Arm-Navigated Occipitocervical Fusion.
O型臂导航下枕颈融合术后螺钉置入的准确性及临床疗效
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Osteoporosis: A Hidden Nonmotor Face of Parkinson's Disease.骨质疏松症：帕金森病隐匿的非运动面容
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Minimum 5-year Follow-up Results for Occipitocervical Fusion Using the Screw-Rod System in Craniocervical Instability.使用螺钉-棒系统治疗颅颈交界区不稳的枕颈融合术至少5年的随访结果
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Epidemiology of Parkinson's disease.帕金森病的流行病学
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