Surgical treatment was desirable to improve neuromuscular function in patients with sustained 3 years fracture-dislocation of lower cervical spine: A case report

Ibrain Pub Date : 2022-07-20 DOI:10.1002/ibra.12054
Hao Yuan, Yu Pi, Chong Wang, Jin-Cheng Si Ma, Sheng Liu, Jun Ao
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Abstract

To investigate the changes in neuromuscular function of anterior approach combined with subtotal vertebral body resection and titanium mesh cage (TMC) internal fixation for the old fracture-dislocated lower cervical spine. A 56-year-old female was admitted to the hospital with neck pain and numbness of the left upper extremity for 3 years due to a fall injury from a height, which worsened for 20 days. Although 3 years had passed, the patient still had significant left limb numbness and decreased muscle strength. Eventually, the patient was diagnosed with the old fracture-dislocation type injury of C6 and C7. C6 was II-degree anterior dislocation and the bilateral joint process was locked, C7 was burst fracture, and C5 was spinal cord segment injury. Then, the operation of the anterior approach combined with subtotal vertebral body resection and TMC internal fixation was performed under general anesthesia. Postoperative symptoms were significantly improved. And during five-year of follow-up, no adverse reactions and complications were reported. Although cervical fracture and dislocation combined with cervical spinal cord injury had persisted for many years, surgical treatment was necessary. The anterior approach combined with subtotal vertebral body resection and TMC internal fixation was desirable to improve neuromuscular function for the old fracture-dislocation of the lower cervical spine, which has some guiding effects on the clinical treatment.

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对于持续三年的下颈椎骨折脱位患者,手术治疗是改善神经肌肉功能的理想方法:病例报告
目的:探讨前路联合椎体次全切除术和钛网笼(TMC)内固定治疗陈旧性骨折脱位下颈椎的神经肌肉功能变化。一位 56 岁的女性患者因高处坠落受伤导致颈部疼痛和左上肢麻木 3 年,入院 20 天后病情加重。虽然已经过去了 3 年,但患者仍有明显的左肢麻木和肌力下降。最终,患者被诊断为C6和C7陈旧性骨折脱位型损伤。C6为Ⅱ度前脱位,双侧关节突锁定,C7为爆裂性骨折,C5为脊髓节段损伤。随后,在全麻下进行了前路联合椎体次全切除和TMC内固定手术。术后症状明显改善。在长达五年的随访中,没有出现任何不良反应和并发症。虽然颈椎骨折和脱位合并颈脊髓损伤已持续多年,但仍有必要进行手术治疗。前路结合椎体次全切除和TMC内固定术对改善下颈椎陈旧性骨折脱位的神经肌肉功能是可取的,对临床治疗有一定的指导作用。
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