背景:成人颈椎后凸畸形是一种发病率低但损伤严重的疾病。本文报告一例医源性损伤引起的严重颈椎后凸症。病例简介:患者40年前因颈部肿瘤接受C3~C6椎板切除术,13年前出现脊髓压迫的渐进性症状。3年前,接受了前后路颈椎手术。术后随访2年,颈椎后凸矫正,肢体麻木和疲劳症状改善,JOA评分10分,双上肢疼痛消失,双下肢肌力恢复至Ⅳ级。结论:医源性损伤引起的颈椎后凸畸形是罕见的。通常需要多次手术,手术方法存在复杂性、灵活性,但有时仅行前后路联合松解+后路截骨矫形及固定可以减少手术次数,降低手术风险,达到预期效果,是可供选择的手术方式。
Data background: Adultcervical kyphosis is a disease with low incidence but great damage. This paper reported a case of severe cervical kyphosis caused by iatrogenic injury. Case Introduction: The patient underwent C3~C6 laminectomy for cervical tumor 40 years ago and developed progres-sive symptoms of spinal cord compression 13 years ago. 3 years ago, he underwent anterior and posterior cervical spine surgery. After 2 years of follow-up, cervical kyphosis was corrected, limb numbness and fatigue symptoms improved, JOA score was 10, pain in both upper limbs disap-peared, and muscle strength in both lower limbs recovered to grade IV. Conclusion: Cervical kypho-sis due to iatrogenic injury is rare. Usually multiple operations are required, and the surgical method is complicated and flexible, but sometimes only anterior posterior release + posterior oste-otomy and fixation can reduce the number of operations, reduce the risk of surgery, and achieve the desired effect. It is also a treatment option.
严重颈椎后凸,多次手术,颈椎椎板切除术,手术技术, Severe Cervical Kyphosis Multiple Surgery Cervical Laminectomy Surgical Technique摘要
Data background: Adultcervical kyphosis is a disease with low incidence but great damage. This paper reported a case of severe cervical kyphosis caused by iatrogenic injury. Case Introduction: The patient underwent C3~C6 laminectomy for cervical tumor 40 years ago and developed progressive symptoms of spinal cord compression 13 years ago. 3 years ago, he underwent anterior and posterior cervical spine surgery. After 2 years of follow-up, cervical kyphosis was corrected, limb numbness and fatigue symptoms improved, JOA score was 10, pain in both upper limbs disappeared, and muscle strength in both lower limbs recovered to grade IV. Conclusion: Cervical kyphosis due to iatrogenic injury is rare. Usually multiple operations are required, and the surgical method is complicated and flexible, but sometimes only anterior posterior release + posterior osteotomy and fixation can reduce the number of operations, reduce the risk of surgery, and achieve the desired effect. It is also a treatment option.
杨浚一,伍伟飞,梁 杰. 手术治疗椎板切除术后重度强直型颈椎后凸1例Surgical Treatment of Severe Rigid Cervical Kyphosis after Laminectomy: A Case Report[J]. 临床医学进展, 2022, 12(11): 10327-10332. https://doi.org/10.12677/ACM.2022.12111489
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