Narakas A O
Orthopade. 1987 Feb;16(1):81-6.
On the one hand, out of 115 patients admitted to hospital with 162 various fractures of the cervical spine without injury to the spinal cord, only 3 (2.6%) had an associated lesion to the brachial plexus or nerves in the vicinity. On the other hand, among 500 consecutive patients with injuries to the brachial plexus, 55 (11%) presented fractures of the cervical spine (including T1 and the 1st rib), whiplash injuries, severe distortions and dislocations, and contusions of that vertebral segment. Five (1% resp. 9%) had spinal cord injuries, including four patients with partial Brown-Sequard's syndrome, which was caused by multilevel root avulsions of the brachial plexus. In rather severe trauma to the lower cervical spine and concomitant brachial plexus lesion, root avulsions must be expected in 83% of cases, and in almost half of these patients three or more roots are avulsed from the spinal cord. Fractures around the shoulder-girdle as well as arterial ruptures are also significant for this severe nerve injury. Of these patients 39 (71%), were victims of motorcycle accidents.
一方面,在115例因162处各种颈椎骨折入院且脊髓未受损的患者中,仅有3例(2.6%)伴有臂丛神经或其附近神经的损伤。另一方面,在连续的500例臂丛神经损伤患者中,55例(11%)出现了颈椎骨折(包括T1和第1肋)、挥鞭样损伤、严重扭曲和脱位以及该椎体节段的挫伤。5例(分别为1%和9%)有脊髓损伤,其中4例患有部分布朗 - 塞卡尔综合征,这是由臂丛神经多节段根性撕脱引起的。在颈椎下段相当严重的创伤并伴有臂丛神经损伤的情况下,83%的病例可预期出现根性撕脱,并且在这些患者中几乎一半有三根或更多神经根从脊髓撕脱。肩胛带周围骨折以及动脉破裂对于这种严重的神经损伤也很重要。这些患者中有39例(71%)是摩托车事故的受害者。