二级医院创伤性脊髓损伤的急诊手术：病例报告
Emergency surgery for traumatic spinal cord injury in a secondary hospital: A case report.
作者信息
Apriawan Tedy, Wicaksono Pandu, Meizikri Rizki, Subagio Eko Agus
机构信息
Department of Neurosurgery, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia.
Department of Neurosurgery, Mitra Keluarga Satelit Hospital, Surabaya, East Java, Indonesia.
出版信息
Surg Neurol Int. 2021 Jul 27;12:375. doi: 10.25259/SNI_333_2021. eCollection 2021.
BACKGROUND
Cervical spinal cord injury (SCI) is a life-threatening condition. Prompt surgical intervention is needed to avoid hemodynamic and respiratory catastrophe. In Indonesia, however, spine surgery is more common in tertiary hospitals and thus might prolong the time gap to surgery due to referral waiting time.
CASE DESCRIPTION
We performed an emergency surgery for a patient with complete SCI due to unstable cervical fracture. The patient was in spinal shock and experienced respiratory arrest after radiological workup. Stability was achieved in the ICU and patient was directly sent to operating theater. Anterior-posterior approach was chosen to decompress and stabilize the cervical spine. The patient was discharged on postoperative day 17 and was seen well at 1-month follow-up.
CONCLUSION
The capability to perform spine procedures should not be exclusive to tertiary hospitals in Indonesia. Satisfying results can be achieved with the presence of capable neurosurgeons or orthopedic surgeons and anesthesiologists in lower-level hospitals.
背景
颈脊髓损伤（SCI）是一种危及生命的病症。需要及时进行手术干预以避免血流动力学和呼吸方面的灾难。然而，在印度尼西亚，脊柱手术在三级医院更为常见，因此由于转诊等待时间，可能会延长手术时间间隔。
病例描述
我们为一名因颈椎骨折不稳定导致完全性脊髓损伤的患者进行了急诊手术。患者处于脊髓休克状态，在影像学检查后出现呼吸骤停。在重症监护病房实现了稳定性，患者被直接送往手术室。选择前后路联合入路来减压和稳定颈椎。患者术后第17天出院，1个月随访时情况良好。
结论
在印度尼西亚，进行脊柱手术的能力不应仅限于三级医院。较低级别医院有能力的神经外科医生、骨科医生和麻醉医生在场，就能取得令人满意的结果。
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