先天性寰枢椎半脱位及相关复杂椎动脉异常的后路减压与关节融合术：一例报告
Posterior Decompression and Arthrodesis in Congenital Atlantoaxial Subluxation and Associated Complex Vertebral Artery Anomaly: A Case Report.
作者信息
Goyal Nikhil, Bhatia Pratibha, Sethy Siddharth S, Chaturvedi Jitendra, Sarkar Bhaskar, Kandwal Pankaj
机构信息
Department of Orthopedics, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India.
出版信息
J Orthop Case Rep. 2025 Aug;15(8):35-40. doi: 10.13107/jocr.2025.v15.i08.5874.
INTRODUCTION
The overall incidence of vertebral artery (VA) variations is 2-3%, but among patients with congenital anomalies at the cranio-vertebral junction, it is 20%. Knowing these anomalies is important, if failed to recognize can lead to VA injury during surgery and subsequent cerebrovascular accidents.
CASE REPORT
A 14-year-old boy presenting with progressive weakness of bilateral upper limb and lower limb was diagnosed as case of supra-axial cervical myelopathy due to congenital atlantoaxial subluxation with fenestration of VA and high-riding VA. The patient underwent posterior decompression and fusion using C1 lateral mass and C2 laminar screw rod construct.
CONCLUSION
A thorough evaluation of the anatomy of the craniovertebral joint is required in congenital pathologies, and a patient-specific treatment approach should be used. Surgical management can effectively alleviate symptoms and prevent complications, but careful consideration must be given to the risks and benefits of different surgical techniques.
引言
椎动脉（VA）变异的总体发生率为2% - 3%，但在颅颈交界先天性畸形患者中，这一比例为20%。了解这些异常情况很重要，因为未能识别可能导致手术期间椎动脉损伤及随后的脑血管意外。
病例报告
一名14岁男孩，表现为双侧上肢和下肢进行性无力，被诊断为由于先天性寰枢椎半脱位伴椎动脉开窗和高位椎动脉导致的轴上型颈椎病。该患者接受了使用C1侧块和C2椎板螺钉棒结构的后路减压和融合手术。
结论
对于先天性疾病，需要对颅颈关节的解剖结构进行全面评估，并应采用针对患者的治疗方法。手术治疗可以有效缓解症状并预防并发症，但必须仔细考虑不同手术技术的风险和益处。
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