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手术治疗有助于改善下颈椎骨折脱位持续3年患者的神经肌肉功能:一例报告。

Surgical treatment was desirable to improve neuromuscular function in patients with sustained 3 years fracture-dislocation of lower cervical spine: A case report.

作者信息

Yuan Hao, Pi Yu, Wang Chong, Ma Jin-Cheng Si, Liu Sheng, Ao Jun

机构信息

Department of Orthopaedic Surgery Affiliated Hospital of Zunyi Medical University Zunyi Guizhou China.

Department of Anesthesiology Southwest Medical University Luzhou Sichuan China.

出版信息

Ibrain. 2022 Jul 20;9(4):473-478. doi: 10.1002/ibra.12054. eCollection 2023 Winter.

Abstract

To investigate the changes in neuromuscular function of anterior approach combined with subtotal vertebral body resection and titanium mesh cage (TMC) internal fixation for the old fracture-dislocated lower cervical spine. A 56-year-old female was admitted to the hospital with neck pain and numbness of the left upper extremity for 3 years due to a fall injury from a height, which worsened for 20 days. Although 3 years had passed, the patient still had significant left limb numbness and decreased muscle strength. Eventually, the patient was diagnosed with the old fracture-dislocation type injury of C6 and C7. C6 was II-degree anterior dislocation and the bilateral joint process was locked, C7 was burst fracture, and C5 was spinal cord segment injury. Then, the operation of the anterior approach combined with subtotal vertebral body resection and TMC internal fixation was performed under general anesthesia. Postoperative symptoms were significantly improved. And during five-year of follow-up, no adverse reactions and complications were reported. Although cervical fracture and dislocation combined with cervical spinal cord injury had persisted for many years, surgical treatment was necessary. The anterior approach combined with subtotal vertebral body resection and TMC internal fixation was desirable to improve neuromuscular function for the old fracture-dislocation of the lower cervical spine, which has some guiding effects on the clinical treatment.

摘要

探讨前路联合椎体次全切除钛网融合器(TMC)内固定治疗陈旧性下颈椎骨折脱位的神经肌肉功能变化。一名56岁女性因高处坠落伤致颈部疼痛伴左上肢麻木3年入院,近20天加重。虽已过去3年,但患者仍有明显的左上肢麻木及肌力下降。最终,患者被诊断为C6、C7陈旧性骨折脱位型损伤。C6为Ⅱ度前脱位,双侧关节突绞锁,C7为爆裂骨折,C5为脊髓节段性损伤。随后,在全身麻醉下行前路联合椎体次全切除及TMC内固定手术。术后症状明显改善。随访5年期间,未报告不良反应及并发症。虽然颈椎骨折脱位合并颈脊髓损伤已持续多年,但手术治疗仍有必要。前路联合椎体次全切除及TMC内固定对改善陈旧性下颈椎骨折脱位的神经肌肉功能具有积极意义,对临床治疗有一定的指导作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f95/11045180/67e2a8138ab6/IBRA-9-473-g001.jpg

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