Cui Hao-Cheng, Chang Zheng-Qi, Zhao Shao-Ke
Department of Orthopedic Surgery, 960 Hospital of PLA, Jinan 250031, Shandong Province, China.
World J Orthop. 2024 Oct 18;15(10):981-990. doi: 10.5312/wjo.v15.i10.981.
Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.
We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy (CSR) who was scheduled for anterior cervical decompression and fusion. During post-anesthetic positioning, a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended. This surge was promptly reversed through cervical flexion and head elevation. This event however required an alternate surgical approach for recovery-posterior laminoplasty and endoscopy-assisted nucleus pulposus removal. Following the 6-month outpatient follow-up period, cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.
Maintaining a safe hypotensive posture and performing rapid, thorough decompression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies (HE). This would mitigate the underlying causes of these HEs.
广泛研究表明，目前尚无关于颈椎姿势改变引发高血压急症的报道。
我们在此介绍一名57岁女性，被诊断为神经根型颈椎病（CSR），计划接受颈椎前路减压融合术。在麻醉后体位摆放过程中，当患者处于颈部稍伸展的仰卧位时，突然出现高血压激增。通过颈椎屈曲和抬头，这种激增迅速得到逆转。然而，这一事件需要采用另一种手术方法进行恢复——后路椎板成形术和内镜辅助下髓核摘除术。经过6个月的门诊随访期，患者的颈椎屈伸活动有了显著改善，且未出现急性血压升高的情况。
对于出现类似神经根型颈椎病症状并伴有高血压急症（HE）的患者，保持安全的低血压姿势并进行快速、彻底的减压手术可能是有效的干预措施。这将减轻这些高血压急症的潜在病因。
