颈椎小关节脱位中椎动脉和脊髓前动脉闭塞：前瞻性 CT 血管造影研究。
Occlusion of vertebral artery and anterior spinal artery in cervical facet dislocation: a prospective study using computed tomography angiography.
机构信息
Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
出版信息
Spinal Cord Ser Cases. 2024 Jul 23;10(1):50. doi: 10.1038/s41394-024-00664-z.
STUDY DESIGN
A prospective study.
OBJECTIVE
To investigate the incidence of vertebral artery (VA) occlusion and whether anterior spinal artery (ASA) is occluded in cervical facet dislocation.
SETTING
University hospital, China.
METHODS
During a 2-year period, 21 conventional patients with cervical facet dislocation were prospectively enrolled. All patients received computed tomography angiography (CTA) to assess the patency of the VA, anterior radiculomedullary arteries (ARAs), and ASA at the time of injury. Clinical data were documented, including demographics, symptomatic vertebrobasilar ischemia, American Spinal Injury Association Impairment Scale (ASIA) grades, and ASA and VA radiological characteristics.
RESULTS
VA unilateral occlusion occurred in 5 of 21 patients (24%), including 2 with unilateral facet dislocation and 3 with bilateral facet dislocation. No ASA occlusion was found in all 21 patients, including 5 with VA unilateral occlusion. No patients had symptomatic vertebrobasilar ischemia.
CONCLUSIONS
VA occlusion occurs in approximately one-fourth of cervical facet dislocations, with infrequent symptomatic vertebrobasilar ischemia. ASA is not occluded following cervical facet dislocation, even with unilateral VA occlusion.
研究设计
前瞻性研究。
目的
探讨颈椎小关节脱位患者椎动脉（VA）闭塞的发生率，以及颈前脊髓动脉（ASA）是否闭塞。
地点
中国一家大学医院。
方法
在 2 年期间，前瞻性纳入了 21 例常规颈椎小关节脱位患者。所有患者在受伤时均接受计算机断层血管造影（CTA）以评估 VA、前根髓动脉（ARAs）和 ASA 的通畅性。记录临床资料，包括人口统计学特征、症状性椎基底动脉缺血、美国脊髓损伤协会损伤分级（ASIA）以及 ASA 和 VA 的影像学特征。
结果
21 例患者中有 5 例（24%）出现 VA 单侧闭塞，其中 2 例为单侧小关节脱位，3 例为双侧小关节脱位。21 例患者均未发现 ASA 闭塞，其中 5 例 VA 单侧闭塞。无患者出现症状性椎基底动脉缺血。
结论
约四分之一的颈椎小关节脱位患者发生 VA 闭塞，且很少出现症状性椎基底动脉缺血。即使 VA 单侧闭塞，颈小关节脱位后 ASA 也不会闭塞。
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