Tang Ruo-Hui, Yin Jin, Zhou Zhao-Wen
Department of Orthopedic, The First People's Hospital of Kunming, Kunming 650000, Yunnan Province, China.
World J Orthop. 2025 Feb 18;16(2):104095. doi: 10.5312/wjo.v16.i2.104095.
Surgical intervention is a critical treatment approach for symptomatic atlantoaxial dislocation. However, vertebral artery injury remains a significant challenge during such procedures. We present a case of successful treatment of atlantoaxial dislocation with concurrent vertebral artery injury using interlaminar screw technology, and review the relevant literature.
A 69-year-old female patient, with no history of trauma, was diagnosed with atlantoaxial dislocation based on X-ray, computed tomography (CT), and magnetic resonance imaging. Preoperative CT angiography (CTA) revealed vertebral artery developmental anomalies, and she underwent posterior cervical surgery. Postoperative follow-up showed improvement in the patient's clinical symptoms such as unstable walking and dizziness, as well as functional scores compared to pre-surgery. Intraoperative vertebral artery injury was successfully managed, and postoperative CTA review revealed no complications related to vascular damage.
Thorough preoperative evaluation, such as CTA imaging, and the surgeon's expertise in various spinal screw placement techniques are crucial for improving the success rate of atlantoaxial dislocation surgeries.
手术干预是症状性寰枢椎脱位的关键治疗方法。然而,在此类手术过程中椎动脉损伤仍然是一个重大挑战。我们报告一例使用椎板间螺钉技术成功治疗合并椎动脉损伤的寰枢椎脱位病例,并回顾相关文献。
一名69岁女性患者,无外伤史,经X线、计算机断层扫描(CT)和磁共振成像诊断为寰枢椎脱位。术前CT血管造影(CTA)显示椎动脉发育异常,她接受了后路颈椎手术。术后随访显示,患者行走不稳和头晕等临床症状以及功能评分较术前有所改善。术中成功处理了椎动脉损伤,术后CTA复查未发现与血管损伤相关的并发症。
全面的术前评估,如CTA成像,以及外科医生在各种脊柱螺钉置入技术方面的专业知识对于提高寰枢椎脱位手术的成功率至关重要。