PDF(Pubmed)
Abstract：
UNASSIGNED: There are few reports of cases with vertical subluxation. We report our experience of a vertical subluxation of the atlantoaxial joint caused by infection.
UNASSIGNED: A 63-year-old man had a 5-month history of neck pain. He was treated for rheumatoid arthritis by a local doctor. At admission to our hospital, he had neck pain and complained of dysphagia and hoarseness. His white blood cell count and C-reactive protein were 7200/mm3 and 4.86 mg/dL. Cervical X-ray showed atlantoaxial subluxation. Computed tomography showed osteolysis around the odontoid process, including the atlantooccipital and atlantoaxial joints, causing vertical subluxation. Magnetic resonance imaging showed spinal cord and brainstem compression and the presence of fluid. Gadolinium-enhanced magnetic resonance imaging showed enhancement around the odontoid process. We performed occipital-cervical spine fixation and C1 laminectomy. Following surgery, his symptoms completely resolved. Bone fusion was confirmed 6 months after surgery.
UNASSIGNED: If subluxation of the upper cervical spine occurs rapidly, infection should be considered.
UNASSIGNED: A 63-year-old man had a 5-month history of neck pain. He was treated for rheumatoid arthritis by a local doctor. At admission to our hospital, he had neck pain and complained of dysphagia and hoarseness. His white blood cell count and C-reactive protein were 7200/mm3 and 4.86 mg/dL. Cervical X-ray showed atlantoaxial subluxation. Computed tomography showed osteolysis around the odontoid process, including the atlantooccipital and atlantoaxial joints, causing vertical subluxation. Magnetic resonance imaging showed spinal cord and brainstem compression and the presence of fluid. Gadolinium-enhanced magnetic resonance imaging showed enhancement around the odontoid process. We performed occipital-cervical spine fixation and C1 laminectomy. Following surgery, his symptoms completely resolved. Bone fusion was confirmed 6 months after surgery.
UNASSIGNED: If subluxation of the upper cervical spine occurs rapidly, infection should be considered.
摘要：
■很少有垂直半脱位病例的报告。我们报告了由感染引起的寰枢关节垂直半脱位的经验。
■一名63岁男子有5个月的颈部疼痛史。当地医生为他治疗了类风湿性关节炎。入院时，他有颈部疼痛，并抱怨吞咽困难和声音嘶哑。白细胞计数和C反应蛋白分别为7200/mm3和4.86mg/dL。颈椎X线片显示寰枢关节半脱位。计算机断层扫描显示齿状突周围骨质溶解，包括寰枕关节和寰枢关节，导致垂直半脱位。磁共振成像显示脊髓和脑干受压以及液体的存在。钆增强磁共振成像显示齿状突周围增强。我们进行了枕-颈椎固定术和C1椎板切除术。手术后,他的症状完全缓解。术后6个月确认骨融合。
■如果上颈椎脱位迅速发生，应该考虑感染。
■一名63岁男子有5个月的颈部疼痛史。当地医生为他治疗了类风湿性关节炎。入院时，他有颈部疼痛，并抱怨吞咽困难和声音嘶哑。白细胞计数和C反应蛋白分别为7200/mm3和4.86mg/dL。颈椎X线片显示寰枢关节半脱位。计算机断层扫描显示齿状突周围骨质溶解，包括寰枕关节和寰枢关节，导致垂直半脱位。磁共振成像显示脊髓和脑干受压以及液体的存在。钆增强磁共振成像显示齿状突周围增强。我们进行了枕-颈椎固定术和C1椎板切除术。手术后,他的症状完全缓解。术后6个月确认骨融合。
■如果上颈椎脱位迅速发生，应该考虑感染。
