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[创伤性C7-T1椎体滑脱,无神经功能缺损]

[Traumatic spondyloptosis C7-T1 without neurologic deficit].

作者信息

Gómez-Flores G, Gutiérrez-Herrera L E, Dufoo-Olvera M, Ladewig-Bernáldez G I, Collado-Arce M G L, Oropeza-Oropeza E, López-Palacios J J, García-López O, May-Martínez E D, Pérez-Jacobo G, Silvas-Vásquez M R

机构信息

Clínica de Columna de la Secretaría de Salud de la Ciudad de México. Hospital General «La Villa». México.

出版信息

Acta Ortop Mex. 2020 Nov-Dec;34(6):412-416.

Abstract

Traumatic spondyloptosis is a serious injury usually caused by high-energy trauma; It consists of the anterior or posterior dislocation of 100% or more of the underlying vertebral body, which can become a total injury of the spinal cord, producing a neurological deficit; this type of injury represents stage 4 and 5 of Allen-Ferguson. A 50-year-old man who suffers a car accident, he receive frontal impact when he was a driver, colliding with the retaining wall, referred from another hospital to emergency room, managed with C7 hemicorpectomy, c7-t1 discectomy, spondylodesis with anterior plate (C6-T1), and posterior approach + Fascetectomies of C7-T1, facet joint screws C6 and transpedicular fixation of T1. Subaxial cervical spondyloptosis is relatively rare clinical entity, a complete clinical examination is important in diagnosis, taking in considerations the injury mechanism. For treatment we have a multiple options, at this case anterior-posterior (360 degrees) treatment it was the better option for Us; however, must be personalized and consider the early rehabilitation of patient.

摘要

创伤性椎体滑脱是一种通常由高能量创伤引起的严重损伤;它包括下方椎体100%或更多的前后脱位,可导致脊髓完全损伤,产生神经功能缺损;这种损伤类型代表Allen-Ferguson的4期和5期。一名50岁男性遭遇车祸,他作为司机时受到正面撞击,与挡土墙相撞,从另一家医院转诊至急诊室,接受了C7半椎体切除术、C7-T1椎间盘切除术、前路钢板融合术(C6-T1)以及后路手术+C7-T1椎板切除术、C6关节突关节螺钉和T1椎弓根固定术。下颈椎椎体滑脱是一种相对罕见的临床病症,全面的临床检查对诊断很重要,同时要考虑损伤机制。对于治疗我们有多种选择,在这个病例中,前后路(360度)治疗对我们来说是更好的选择;然而,治疗必须个性化,并考虑患者的早期康复。

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