Cervical Hyperextension Deformity After Sagittal Balance Correction in Patient with Congenital Limb-Girdle Myopathy: Surgical Technique and Review of Literature.
Cervical Hyperextension Deformity After Sagittal Balance Correction in Patient with Congenital Limb-Girdle Myopathy: Surgical Technique and Review of Literature.
复制标题
先天性肢带肌病患者矢状面平衡矫正后颈椎过伸畸形：手术技术和文献回顾。
DOI：
10.1016/j.wneu.2018.10.211
复制
发表时间：
2019
影响因子：
2
通讯作者：
T. Rizk
中科院分区：
文献类型：
--
作者：
Elie Fahed;M. Grelat;P. Younes;R. Madkouri;G. Kreichati;K. Kharrat;T. Rizk
背景颈椎过伸畸形的手术治疗尚无金标准，尤其是肌营养不良患者。应特别注意和谨慎，因为它们具有早期死亡和脊髓损伤的高风险。文献中仅有少数病例报道。病例描述我们报告一例先天性肢带肌病患者在矢状面平衡矫正后手术矫正医源性颈椎过伸畸形。患者在验证活动范围、畸形复位、并且在所需的术后位置进行动态放射学检查和术前磁共振成像，没有任何位置性脊髓压迫。结论对于放射学和临床上可还原的运动和运动下的颈部过伸畸形，我们建议后路颈椎松解和融合感觉脊髓诱发电位监测。对于长期存在的、僵硬的、不可复位的颈椎过伸，可以考虑椎板切除术和同时进行的硬脊膜成形术。
BackgroundThere is no gold standard surgical treatment for cervical hyperextension deformity, especially in case of muscular dystrophy. Special considerations and caution should be taken as they carry a high risk of early mortality and spinal cord injury. Only a few case reports are available in the literature.Case DescriptionWe report a case of surgical correction of an iatrogenic cervical hyperextension deformity following sagittal balance correction in a patient with congenital limb-girdle myopathy.The patient was successfully treated by posterior cervical release and fusion after verification of the range of motion, reducibility of the deformity, and absence of any positional spinal cord compression with dynamic radiographic examination and preoperative magnetic resonance imaging in the desired postoperative position.ConclusionsWe suggest posterior cervical release and fusion in case of a radiologically and clinically reducible cervical hyperextension deformity under both motor and sensory spinal evoked potential monitoring. In cases of longstanding, rigid, nonreducible cervical hyperextension, laminectomy and concomitant duroplasty could be considered.