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

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (3)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2025447, encodeId=5504202544e99, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Oct 21 14:04:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335140, encodeId=bc27133514026, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Fri May 05 23:04:00 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193626, encodeId=9c621936262c, content=学习,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Thu May 04 08:59:05 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-10-21 amyloid
  2. [GetPortalCommentsPageByObjectIdResponse(id=2025447, encodeId=5504202544e99, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Oct 21 14:04:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335140, encodeId=bc27133514026, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Fri May 05 23:04:00 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193626, encodeId=9c621936262c, content=学习,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Thu May 04 08:59:05 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2025447, encodeId=5504202544e99, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Oct 21 14:04:00 CST 2017, time=2017-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335140, encodeId=bc27133514026, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Fri May 05 23:04:00 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193626, encodeId=9c621936262c, content=学习,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Thu May 04 08:59:05 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 执着追梦

    学习,感谢分享!

    0