Permana Galih Indra
Department of Neurosurgery, Airlangga University - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia.
Surg Neurol Int. 2020 Dec 4;11:415. doi: 10.25259/SNI_666_2020. eCollection 2020.
Hangman's fractures are one of the most frequent types of high cervical spine injuries. Here, we present a quadriplegic patient due to a hangman's fracture treated during the coronavirus 2019 (COVID-19) pandemic.
A 19-year-old male was quadriplegic and in spinal shock following a motor vehicle accident. X-rays showed a C2 hangman's fracture with instability. X-rays and CT studies both confirmed anterior dislocation at C2 on C3 with bilateral pedicle C2 fractures and 5 mm of subluxation. In addition, he had an infiltrate in both lungs consistent with the diagnosis of COVID-19. The patient was intubated for respiratory failure and hemodynamically stabilized for his spinal shock. Unfortunately, before surgical intervention could be undertaken, the patient sustained a fatal cardiorespiratory arrest.
Utilizing appropriate personal protective equipment, it was and should be possible to treat patients with spinal injuries in the presence of active COVID infection. However, the risks of treating such spinal urgencies and emergencies should be thoroughly discussed with the entire nonsurgical and surgical treatment teams (e.g., including anesthesiologists, physicians, nurses, and other caregivers).
绞刑者骨折是高颈椎损伤中最常见的类型之一。在此，我们介绍一例在2019年冠状病毒病（COVID-19）大流行期间因绞刑者骨折导致四肢瘫痪的患者。
一名19岁男性在机动车事故后出现四肢瘫痪并处于脊髓休克状态。X线显示C2绞刑者骨折伴不稳定。X线和CT检查均证实C2椎体相对于C3椎体向前脱位，伴有双侧C2椎弓根骨折和5毫米半脱位。此外，他双肺有浸润影，符合COVID-19诊断。患者因呼吸衰竭行气管插管，并对其脊髓休克进行血流动力学稳定治疗。不幸的是，在进行手术干预之前，患者发生了致命的心肺骤停。
使用适当的个人防护设备，在存在活动性COVID感染的情况下治疗脊柱损伤患者过去是、现在也应该是可行的。然而，对于此类脊柱急症的治疗风险，应与整个非手术和手术治疗团队（例如包括麻醉师、医生、护士和其他护理人员）进行充分讨论。
