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新冠疫情时代的颈椎骨折:病例系列

Cervical Fracture During COVID-19 Pandemic Era: A Case Series.

作者信息

Utomo Pamudji, Prijosedjati R Andhi, Malik Ricat Hinaywan

机构信息

Department of Orthopedics & Traumatology, Prof. Dr. R. Soeharso Orthopedic Hospital/Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.

Orthopedics & Traumatology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.

出版信息

Open Access Emerg Med. 2021 Dec 7;13:535-542. doi: 10.2147/OAEM.S319748. eCollection 2021.

Abstract

BACKGROUND

Cervical fractures are potentially serious and can have fatal consequences if not treated properly. Correct diagnosis and classification of injury is the first step in determining the most appropriate treatment. Cervical fractures will have an impact on the patient's work, and COVID-19 is a challenge in the hospital to treat a cervical fracture. This study aims to discuss the case of patients with cervical fractures that have undergone surgical treatment in the COVID-19 pandemic.

CASE PRESENTATION

Two cases of emergency patients with cervical injury treated at the hospital in the acute setting of the COVID-19 pandemic. All these patients experienced delayed timing to arrive in the emergency department of Prof. Dr. R. Soeharso Orthopedic Hospital. Neurological outcome was assessed before being discharged after surgery and a 3-month follow-up post-surgery.

RESULTS

Laminectomy and posterior stabilization and fusion (PSF) were performed immediately after diagnosis was established in both patients. Physical rehabilitation was performed. In a 3-month follow-up, both patients' neurological functions improved.

CONCLUSION

Clinical outcomes of cervical injury patients can be affected by some factors, for example, timing to diagnosis, timing to traction application, timing to surgery, and timing to rehabilitation. Depending on the institution, weekend days can also affect the delay of the COVID-19 PCR swab. MRI schedule and patient optimal condition can also affect the timing to surgery. The immediate diagnosis and prompt treatment are needed to make a better outcome, especially better neurological status.

摘要

背景

颈椎骨折可能很严重,如果治疗不当可能会导致致命后果。准确诊断和损伤分类是确定最合适治疗方法的第一步。颈椎骨折会影响患者的工作,而新型冠状病毒肺炎(COVID-19)给医院治疗颈椎骨折带来了挑战。本研究旨在探讨在COVID-19大流行期间接受手术治疗的颈椎骨折患者的病例。

病例介绍

在COVID-19大流行的急性期,医院治疗了两例颈椎损伤急诊患者。所有这些患者到达R. Soeharso教授骨科医院急诊科的时间都有所延迟。在手术后出院前及术后3个月随访时评估神经功能结果。

结果

两名患者确诊后均立即进行了椎板切除术及后路稳定融合术(PSF)。进行了物理康复治疗。在3个月的随访中,两名患者的神经功能均有改善。

结论

颈椎损伤患者的临床结果可能受某些因素影响,例如诊断时间、牵引应用时间、手术时间和康复时间。根据机构不同,周末也可能影响COVID-19核酸拭子检测的延迟。磁共振成像(MRI)检查安排和患者的最佳状态也可能影响手术时间。需要立即诊断并及时治疗以取得更好的结果,尤其是更好的神经状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7a4/8665776/e599235ac83b/OAEM-13-535-g0001.jpg

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