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NEJM:创伤性枢椎滑脱-案例报道

2017-05-04 xing.T MedSci原创

创伤性枢椎滑脱,亦称Hangman骨折,是由颈部过度牵张引起的。这些骨折是根据前后位移偏差程度、有无后纵韧带断裂、骨折线的位置以及有无小关节脱位的存在来进行分类。

患者为一名25岁的男性,因交通事故后出现严重颈部疼痛而到急诊就诊。该患者的手臂和大腿有力,轻触觉和针刺觉正常,无括约肌障碍。

侧位片(如图A)显示,C2和C3椎体之间的椎间盘破裂,C2椎体后角成为碎片,左侧椎弓根轴向骨折,并伴有前下部位有一个小碎片(如图中箭头所示)。轴向断层扫描(如图B)确认为右侧和左侧C2椎体左椎弓根骨折。


创伤性枢椎滑脱,亦称Hangman骨折,是由颈部过度牵张引起的。这些骨折是根据前后位移偏差程度、有无后纵韧带断裂、骨折线的位置以及有无小关节脱位的存在来进行分类。

稳定骨折同时位移最小的情况可能通过外部固定进行保守治疗,但对于不稳定的骨折,正如这个患者,需要手术进行固定。

该患者接受了C2和C3椎骨的前路融合术,并在随访4年后,该患者没有神经功能缺损以及疼痛。

原始出处:

Anis Khelifi,et al. Traumatic Spondylolisthesis of the Axis.N Engl J Med 2017; 376: http://www.nejm.org/doi/full/10.1056/NEJMicm1405867

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