Tiberin P, Hertzanu Y
Service de Neurochirurgie, Hôpital Soroka, Centre Universitaire des Sciences de la Santé, Université Ben Gourion, Beer-Sheva, Israël.
Neurochirurgie. 1994;40(6):381-7.
The authors present their experience with an unusual case of fracture of the lower cervical spine with complete dislocation at C6-C7 level, in a young man involved in a car accident. An initial unilateral root deficit progressed shortly after admission to hospital, to a classical Brown-Sequard' syndrome. The development of a partial cord lesion in spite of the severe dislocation of the spine, could be attributed to the simultaneous "traumatic laminotomy" and the enlargement of the neural canal at the level of the vertebral sliding, that occurred as a result of bilateral fracture of the posterior arc of the 6th cervical vertebra and its separation from the anteriorly displaced vertebral body. Our management consisted in cortico-therapy and early skeletal traction with prolonged immobilization of the cervical column. The closed, rapid reduction of the dislocation under neurologic and radiologic monitoring was followed by successful alignment of the neural canal at 48 hours after injury, with progressive neurologic recovery and by "auto-fusion" of the fractured bones with subsequent, stable and long-lasting consolidation.
作者介绍了一名因车祸受伤的年轻男性下颈椎骨折并伴有C6 - C7水平完全脱位的罕见病例的治疗经验。入院时最初表现为单侧神经根功能缺损，入院后不久进展为典型的布朗 - 色夸综合征。尽管脊柱严重脱位，但仍出现部分脊髓损伤，这可能归因于同时发生的“创伤性椎板切除术”以及由于第六颈椎后弓双侧骨折及其与向前移位的椎体分离导致椎体滑动水平神经根管扩大。我们的治疗方法包括皮质激素治疗和早期骨骼牵引，并对颈椎进行长期固定。在神经和放射学监测下对脱位进行闭合、快速复位，受伤后48小时神经根管成功对齐，神经功能逐渐恢复，骨折部位“自体融合”，随后实现稳定且持久的愈合。
