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[寰枢椎、寰枕关节脱位,埃勒斯-丹洛斯综合征中的发育性颈椎管狭窄(作者译)]

[Atlanto-axial, Atlanto-occipital dislocations, developmental cervical canal stenosis in the Ehlers-Danlos syndrome (author's transl)].

作者信息

Nagashima C, Tsuji R, Kubota S, Tajima K

出版信息

No Shinkei Geka. 1981 Apr;9(5):601-8.

PMID:7242840
Abstract

Clinical, biological, histopathological and laboratory data are reported on a 13-year-old male with atlanto-axial, atlanto-occipital hypermobilities, cervical canal stenosis, hypoplastic atlas and hypoplastic first rib in the Ehlers-Danlos syndrome. He developed frequent attacks of sudden tetraplegia or tetraparesis and numbness below C2 due to trivial neck injuries. Examination revealed marked hypermobilities of all joints the cutis elastica (Fig. 1), spastic tetraparesis and fasciculation of the tongue. Occipito-atlantal hypermobility measured by Wiesel and Rhothmans' method revealed 5 mm horizontal translation (Fig. 2). Anterior and lateral dislocations of atlanto-axial joints were marked due to laxicity of the joint. Posterior decompression of C1, laminotomy of C2,3, occipito-C2 fixation with autogenous iliac "board (3 X 6 cm, rectangular board) graft" yielded favorable results with 15 months follow-up. To our knowledge, this is the first patient reported with this unusual combinations.

摘要

报告了一名13岁男性埃勒斯-当洛综合征患者的临床、生物学、组织病理学和实验室数据,该患者存在寰枢椎、寰枕关节活动过度、颈椎管狭窄、寰椎发育不全和第一肋骨发育不全。他因轻微颈部损伤频繁发作突发四肢瘫或四肢轻瘫以及C2以下麻木。检查发现所有关节、弹性皮肤均有明显活动过度(图1),痉挛性四肢轻瘫和舌肌束颤。采用维泽尔和罗特曼斯方法测量的寰枕关节活动过度显示水平移位5毫米(图2)。由于关节松弛,寰枢关节前脱位和侧方脱位明显。对C1进行后路减压、C2、3椎板切除术,采用自体髂骨“板(3×6厘米,矩形板)移植”进行枕颈固定,随访15个月取得了良好效果。据我们所知,这是首例报告的具有这种不寻常组合的患者。

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