PDF(Pubmed)
Abstract：
BACKGROUND: Complete fractures and dislocations of the lower cervical spine are usually associated with severe spinal cord injury. However, a very small number of patients do not have severe spinal cord injury symptoms, patients with normal muscle strength or only partial nerve root symptoms, known as \"lucky fracture dislocation\". The diagnosis and treatment of such patients is very difficult. Recently, we successfully treated one such patient.
METHODS: A 73-year-old male patient had multiple neck and body aches after trauma, but there was sensory movement in his limbs. However, preoperative cervical radiographs showed no significant abnormalities, and computed tomography (CT) and magnetic resonance imaging (MRI) confirmed complete fracture and dislocation of C7. Before operation, the halo frame was fixed traction, but the reduction was not successful. Finally, the fracture reduction and internal fixation were successfully performed by surgery. The postoperative pain of the patient was significantly relieved, and the sensory movement of the limbs was the same as before. Two years after surgery, the patient\'s left little finger and ulnar forearm shallow sensation recovered, and the right flexion muscle strength basically returned to normal.
CONCLUSIONS: This case suggests that when patients with trauma are encountered in the clinic, they should be carefully examined, and the presence of cervical fracture and dislocation should not be ignored because of the absence of neurological symptoms or mild symptoms. In addition, positioning during handling and surgery should be particularly avoided to increase the risk of paralysis.
METHODS: A 73-year-old male patient had multiple neck and body aches after trauma, but there was sensory movement in his limbs. However, preoperative cervical radiographs showed no significant abnormalities, and computed tomography (CT) and magnetic resonance imaging (MRI) confirmed complete fracture and dislocation of C7. Before operation, the halo frame was fixed traction, but the reduction was not successful. Finally, the fracture reduction and internal fixation were successfully performed by surgery. The postoperative pain of the patient was significantly relieved, and the sensory movement of the limbs was the same as before. Two years after surgery, the patient\'s left little finger and ulnar forearm shallow sensation recovered, and the right flexion muscle strength basically returned to normal.
CONCLUSIONS: This case suggests that when patients with trauma are encountered in the clinic, they should be carefully examined, and the presence of cervical fracture and dislocation should not be ignored because of the absence of neurological symptoms or mild symptoms. In addition, positioning during handling and surgery should be particularly avoided to increase the risk of paralysis.
摘要：
背景：下颈椎完全骨折和脱位通常与严重的脊髓损伤有关。然而,极少数患者没有严重的脊髓损伤症状，肌力正常或仅部分神经根症状的患者，被称为“幸运骨折脱位”。此类患者的诊断和治疗非常困难。最近,我们成功治疗了一个这样的病人。
方法：一名73岁的男性患者在外伤后出现多处颈部和身体疼痛，但是他的四肢有感觉运动。然而,术前宫颈X光片显示无明显异常，计算机断层扫描（CT）和磁共振成像（MRI）证实C7完全骨折和脱位。操作前,光环框架是固定的牵引力，但是减少并不成功。最后,骨折复位内固定手术成功。患者术后疼痛明显缓解,四肢的感觉运动和以前一样。手术两年后,病人的左手小指和尺骨前臂浅感觉恢复，右屈肌力量基本恢复正常。
结论：此病例提示，当患者在临床中遇到创伤时，他们应该仔细检查，并且颈椎骨折和脱位的存在不应被忽视，因为没有神经症状或轻度症状。此外,在操作和手术期间应特别避免定位,以增加瘫痪的风险.
方法：一名73岁的男性患者在外伤后出现多处颈部和身体疼痛，但是他的四肢有感觉运动。然而,术前宫颈X光片显示无明显异常，计算机断层扫描（CT）和磁共振成像（MRI）证实C7完全骨折和脱位。操作前,光环框架是固定的牵引力，但是减少并不成功。最后,骨折复位内固定手术成功。患者术后疼痛明显缓解,四肢的感觉运动和以前一样。手术两年后,病人的左手小指和尺骨前臂浅感觉恢复，右屈肌力量基本恢复正常。
结论：此病例提示，当患者在临床中遇到创伤时，他们应该仔细检查，并且颈椎骨折和脱位的存在不应被忽视，因为没有神经症状或轻度症状。此外,在操作和手术期间应特别避免定位,以增加瘫痪的风险.
