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C5神经根麻痹:一种罕见的术后并发症及其处理

C5 Nerve Root Palsy: An Uncommon Postoperative Complication and Its Management.

作者信息

Seth Nikita H, Joshi Medhavi V, Phansopkar Pratik

机构信息

Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Sep 9;14(9):e28988. doi: 10.7759/cureus.28988. eCollection 2022 Sep.

Abstract

The standard treatment for multiple levels of cervical prolapsed intervertebral disk (PIVD) is anterior cervical decompression and fusion. Although it is associated with positive outcomes, it is also fraught with complications. In this report, we present an unusual postoperative case of a 58-year-old male who underwent anterior decompression and cervical fusion at two levels - C4-C5 and C5-C6 - for traumatic PIVD and developed a postoperative complication of unilateral C5 motor palsy, making it difficult for the patient to elevate the shoulder. This postoperative complication had no known cause, but it could be iatrogenic or due to structural variation. There is sparse research on possible ways to avoid this complication. Physiotherapy management is critical in improving the patient's functional recovery. The neck and upper extremity functional measure scale and Neurogenic Claudication Outcome Score (NCOS) scale were used for measuring outcomes. The patient also had a two-year history of tingling and numbness in both lower extremities, which was treated conservatively. The difficulties that physiotherapists encounter in managing this uncommon postoperative complication in addition to the lumbar PIVD make it unique. The key to a better prognosis is early detection and management.

摘要

多节段颈椎间盘突出症(PIVD)的标准治疗方法是颈椎前路减压融合术。尽管该手术有积极的治疗效果,但也充满了并发症。在本报告中,我们介绍了一例不同寻常的术后病例,一名58岁男性因创伤性PIVD在C4 - C5和C5 - C6两个节段接受了前路减压和颈椎融合术,术后出现了单侧C5运动麻痹的并发症,导致患者难以抬起肩部。这种术后并发症的病因不明,但可能是医源性的或由于结构变异所致。关于避免这种并发症的可能方法的研究很少。物理治疗管理对于改善患者的功能恢复至关重要。使用颈部和上肢功能测量量表以及神经源性间歇性跛行结果评分(NCOS)量表来衡量治疗效果。该患者还伴有双下肢两年的刺痛和麻木病史,采用保守治疗。物理治疗师在管理这种除腰椎PIVD外不常见的术后并发症时所遇到的困难使其具有独特性。更好预后的关键是早期发现和管理。

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