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无神经损伤的创伤性颈胸交界区椎体滑脱的手术治疗:一例报告并文献复习

Surgical Management of Traumatic Cervicothoracic Junction Spondyloptosis Without Neurological Injury: A Case Report and Review of the Literature.

作者信息

Alharbi Hani N, Alsager Ghadeer A, Abdulaziz Mohammed, Bhat Rafiq, Surur Saad

机构信息

Orthopaedic Surgery, King Saud Medical City, Riyadh, SAU.

Orthopaedics, King Saud Medical City, Riyadh, SAU.

出版信息

Cureus. 2022 Oct 28;14(10):e30813. doi: 10.7759/cureus.30813. eCollection 2022 Oct.

Abstract

Acute traumatic cervical spondyloptosis in neurologically intact patients is uncommon and involvement of the cervicothoracic junction is rare. Herein, we report a case of traumatic C7-T1 spondyloptosis in a 56-year-old neurologically intact male patient, with radiographic findings of C7-T1 grade V traumatic listhesis associated with C7 floating segment, cord compression with myelomalacia, extensive ligamentum injury, and intervertebral disc traumatic change and protrusion. He underwent global spine fixation starting with a posterior approach. Follow-up at six months showed good outcomes. The patient was neurologically intact and pain-free; radiographs showed well-maintained fusion and alignment. Controversy surrounds the management of cervical fracture dislocation from all aspects, from "when" to "what." This is the first case reporting a 540° posterior-anterior-posterior approach with successful outcomes. The rarity of cervical spondyloptosis without neurologic injury complicates the management approaches. As few cases are reported in cervicothoracic spondyloptosis literature, it is important to report the present case.

摘要

急性创伤性颈椎滑脱在神经功能完好的患者中并不常见,而颈胸段交界处受累则更为罕见。在此,我们报告一例56岁神经功能完好的男性患者发生创伤性C7-T1椎体滑脱的病例,其影像学表现为C7-T1 V级创伤性椎体前移,伴有C7游离节段、脊髓受压伴脊髓软化、广泛的韧带损伤以及椎间盘创伤性改变和突出。他首先接受了后路的全脊柱固定术。六个月的随访显示效果良好。患者神经功能完好且无疼痛;X线片显示融合和对线良好。从“何时”到“如何处理”,颈椎骨折脱位的处理在各个方面都存在争议。这是首例报告采用540°后-前-后入路并取得成功结果的病例。无神经损伤的颈椎滑脱病例罕见,这使得处理方法变得复杂。由于颈胸段椎体滑脱文献中报道的病例较少,因此报告本病例具有重要意义。

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