Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
JBJS Case Connect. 2021 Apr 14;11(2):01709767-202106000-00028. doi: e20.00672.
A 71-year-old woman sustained C1 lateral mass and type 2 odontoid fractures 3 years after C2-T2 anterior-posterior fusion. She was treated with C1-C4 instrumentation without fusion for 9 months followed by instrumentation removal to restore atlantoaxial motion. After instrumentation removal, she maintained clinically relevant cervical lateral bending, rotation, and flexion and extension.
The loss of upper cervical motion after C1-C2 instrumented fusion may be debilitating for patients in the setting of previous subaxial cervical fusion. Temporary instrumentation without fusion may allow for preservation of upper cervical motion in patients with concomitant C1 and C2 fractures above a previous cervical fusion.
一位 71 岁女性，在 C2-T2 前路-后路融合术后 3 年发生 C1 侧块和 2 型齿状突骨折。她接受了 C1-C4 器械固定但未融合治疗 9 个月，随后行器械取出以恢复寰枢关节活动度。取出器械后，她的颈椎侧屈、旋转和屈伸活动度仍具有临床相关性。
对于先前下颈椎融合术后的患者，C1-C2 融合术后上颈椎活动度丧失可能会导致生活质量下降。对于伴有 C1 和 C2 骨折且骨折位于先前颈椎融合上方的患者，临时固定但不融合可能有助于保留上颈椎活动度。
