成人创伤性寰枢椎旋转半脱位——一例报告及文献复习
Traumatic atlantoaxial rotatory subluxation in adults - A case report and literature review.
作者信息
Horsfall Hugo Layard, Gharooni Aref-Ali, Al-Mousa Alaa, Shtaya Anan, Pereira Erlick
机构信息
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom.
Department of General and Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan.
出版信息
Surg Neurol Int. 2020 Nov 6;11:376. doi: 10.25259/SNI_671_2020. eCollection 2020.
BACKGROUND
Traumatic atlantoaxial rotatory subluxation (AARS) is extremely rare in adult versus pediatric populations. Patients usually present with post-traumatic neck pain and torticollis. Surgical management aims at reducing the deformity and stabilizing the spine utilizing external orthotics, and/or internal reduction/fixation.
METHODS
A 65-year-old female fell downstairs at home. She complained of neck pain with right-sided tenderness and torticollis. The radiographic studies and CT scan demonstrated AARS. This led to an emergent open reduction with internal fixation at the C1-C2 level.
RESULTS
We identified 25 similar cases of AARS in the English literature. Patients averaged 28.7 years of age and mostly sustained motor vehicle accidents largely treated with traction/orthotics; only six patients required surgical open reduction/internal fixation.
CONCLUSION
In this case, the patient's C1-C2 deformity required open reduction/internal fixation rather than bracing alone.
背景
与儿童人群相比，创伤性寰枢椎旋转半脱位（AARS）在成人中极为罕见。患者通常表现为创伤后颈部疼痛和斜颈。手术治疗旨在通过外部支具和/或内部复位/固定来减轻畸形并稳定脊柱。
方法
一名65岁女性在家中从楼梯上摔下。她主诉颈部疼痛，右侧有压痛和斜颈。影像学检查和CT扫描显示为AARS。这导致在C1-C2水平紧急进行切开复位内固定。
结果
我们在英文文献中确定了25例类似的AARS病例。患者平均年龄为28.7岁，大多因机动车事故受伤，主要采用牵引/支具治疗；只有6例患者需要手术切开复位/内固定。
结论
在本病例中，患者的C1-C2畸形需要切开复位/内固定，而不是单纯使用支具。
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