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不伴有神经损伤的胸椎骨折脱位.pdf

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Jiangetal.JournalofMedicalCaseReports2014,8:343 JOURNALOFMEDICAL http://www.jmedicalcasereports.com/content/8/1/343CASEREPORTS CASEREPORTOpenAccess Severethoracicspinalfracture-dislocationwithout neurologicalsymptomsandcostalfractures: acasereportandreviewoftheliterature BingJiang,RunchengZhu,QingyanCaoandHongPan* Abstract Introduction:Onlyahigh-energyforcecancausethoracicspinalfracture-dislocationinjuries,andsuchinjuries shouldalwaysbesuspectedinpatientswithpolytrauma.Theinjuryisusuallyaccompaniedbyneurological symptoms.Thereareonlyafewcasesofseverethoracicspinalfracture-dislocationwithoutneurologicalsymptoms intheliterature,anduntilnow,nocaseofseverethoracicspinalfracture-dislocationwithoutneurologicalsymptoms andwithoutcostalfractureshasbeenreported. Casepresentation:A30-year-oldHanChinesemanhadT6toT7vertebralfractureandanterolateraldislocation withoutneurologicalsymptomsandcostalfractures.Thethree-dimensionalreconstructionbycomputed tomographyandmagneticresonanceimagingindicatedtheinjuriesindetail.Apatientwiththoracicspinal fracture-dislocationwithoutneurologicalsymptomsinclinestofurtherdislocationofthespineandsecondary neurologicalinjury;therefore,laminectomy,reductionandinternalfixationswithrodsandscrewsweredone.The outcomewasgood.Severespinalfracture-dislocationwithoutneurologicalsymptomsshouldbeevaluatedin detail,especiallywiththree-dimensionalreconstructionbycomputedtomography.Althoughtreatmentis individualized,reductionandinternalfixationareadvisedforthepatientiftheconditionissuitableforoperation. Conclusions:Severethoracicspinalfracture-dislocationwithoutneurologicalsymptomsandcostalfracturesis frighteninglyrare;anoperationshouldbedoneifthepatient'sconditionpermits. Keywords:Dislocation,Fracture,Thoracicvertebrae Introductionspinalfracture-dislocationisusuallyaccompaniedby Thethoracicspineisstablebecauseofkyphoticalign-completeneurologicaldysfunctionandmultiplecostal ment,ribcageandcostovertebraljoints.Thespinalfractures,butafewpatientswiththoracicspin