不稳定的上脊椎损伤与同时出现的双边脊柱:一个病例报告
Masashi Fujisawa1, Sota Wakahara1, Joji Inamasu1
1Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan.
Asian journal of neurosurgery
|August 25, 2025
概括
在上脊椎受伤时,Ponticulus posticus (PP) 提出了手术挑战. 避免使用C1侧质螺丝的替代固定方法对于预防脊椎动脉损伤至关重要.
科学领域:
- 神经外科
- 骨科手术
- 人体解剖学
背景情况:
- 庞蒂库斯·波斯蒂库斯 (PP) 是亚特拉斯 (C1) 的一个解剖学变异,涉及后部亚特拉斯膜的骨化.
- 脊椎动脉 (VA) 的 V3 段穿过这个孔隙,在 C1 侧面质量螺丝放置时构成风险.
研究的目的:
- 在患有双侧脊柱病的患者中报告不稳定的上脊柱后部固定病例.
- 突出修改手术技术的重要性,以避免在这种情况下造成脊椎动脉损伤.
主要方法:
- 一名70岁的男性患者患有创伤性C2脊髓溶解和C3-4面部脱, 经历了后部固定手术.
- 在手术前的成像显示了双边的, 需要另一个固定策略.
- 手术计划被修改为使用一侧的C1层和另一侧的C1后方螺丝,避免C1侧面质量螺丝的放置.
主要成果:
- 修改后部固定技术在没有手术或术后并发症的情况下成功执行.
- 患者在受伤后27天就转移到康复中心.
结论:
- 脊椎上部的不稳定性需要仔细的手术前规划和个性化的手术固定策略.
- 修改后的技术,如使用C1后或层状,可以安全地实现固定,同时减轻脊椎动脉损伤的风险.
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