360°环状减压、固定重建术治疗T4椎体血管瘤一例报告

患者 男，15岁。因双下肢麻木无力、行走不稳2个月，加重1周入院。查体：脊柱无畸形，活动无明显受限，T4棘突累压痛、叩击痛阳性。[第一段]     

360°环状减压、固定重建术治疗T4椎体血管瘤一例报告

患者 男，15岁。因双下肢麻木无力、行走不稳2个月，加重1周入院。查体：脊柱无畸形，活动无明显受限，T4棘突累压痛、叩击痛阳性。[第一段]     

胸腔巨大孤立性纤维性肿瘤侵犯椎体一例报告

患者男,28岁,腰部、左腹部酸胀痛8年,双下肢麻木乏力、行走不稳、大小便异常3个月余.查体发现：T10棘突压痛明显,左侧胸背部局部隆起,质地中等、无压痛,左下肺叩诊为实音,呼吸音消失,躯干脐平面以下刺痛觉减弱,双下肢肌力下降、肌张力增高,髌阵挛、踝阵挛和巴氏征均为阳性.影像学检查提示：左侧胸腔内巨大占位病灶,内部可见钙化灶,肿瘤侵犯T9.10椎体,压迫相应节段脊髓,心脏及纵隔明显右移.同位素全身骨扫描检查未发现其他病灶.初步诊断为左侧胸腔内巨大肿瘤.     

L3、L4椎体滑脱症1例报告

患者男性，41岁。因扭伤后右腰背反复酸胀不适10余年，加重伴右下肢麻木20d，于2005年7月入院。10余年前，患者不慎扭伤腰部后出现右腰背酸胀不适，行拔罐等治疗后好转，自此劳累后右腰酸胀感加重，休息后减轻，口服非甾体类抗炎药可缓解。     

齿状突完整的创伤性寰椎后脱位1例报告并文献复习

寰枢椎间的稳定性主要依靠寰椎横韧带和枢椎齿状突的完整性,创伤性寰枢椎不稳多是由于横韧带断裂或者齿状突骨折造成,寰椎后脱位应是以齿状突骨折作为前提的。在横韧带和齿状突均完整的情况下,发生寰枢椎间的脱位是十分少见的情况,而齿状突完整的情况下发生寰椎后脱位更是罕见。1969年Haralson和Boyd[1]报告了首例齿状突完整的寰椎后脱位,截至2003年1月,查阅国外文献仅有7例报告,国内尚无相关报告。我们治疗了1例类似病例,报告如下。患者男性,26岁。因颈部外伤后四肢麻痹1个月,于2003年1月23日入院。入院前1个月车祸外伤后昏迷36h,清醒后发…     

隐性脊柱裂致慢性肾功能不全一例

患者：男,14岁。慢性肾功能不全3年,因血液透析后头痛30min于2009年9月8日入院。患者入院前3年由于常年遗尿症到我院儿科就诊,其患者尿蛋白（＋＋＋）,血压170～180／70mmHg,在北京儿童医院就诊,行尿动力学检查：逼尿肌、括约肌失调。     

骨腊填塞止血致双下肢不全瘫一例

患者女,56岁.因“L1骨折内固定术后1年”,再次入院要求手术取出AF钉.入院时患者神清、精神可、步入病房.腰背后正中切口瘢痕;无压痛和叩击痛;腰背部活动正常;双下肢感觉、运动正常.X线片示L1骨折AF钉内固定术后,骨折愈合,L2椎弓根2枚螺钉均断裂.入院后完善术前检查,术前讨论有手术适应证、无明显禁忌.但手术有一定困难,须凿除断钉周围部分骨质方可取出断钉,这样势必破坏L2椎弓根,从而影响脊柱的稳定,甚至可能引起医源性的L2骨折和脑脊液漏.     

Locked unifacet dislocation L3 on L4 vertebra. A case report

Unifacet dislocation of the lumbar spine, without fracture of the posterior elements on the opposite side, is a rare injury. A patient with this injury at the L3/L4 level is described. A satisfactory outcome was achieved using open reduction and internal fixation with plate and intrapeduncular screws.     

不伴神经功能损伤的齿突骨折合并吁度寰椎后脱位一例报告

 寰枢椎脱位是指在外伤或其他因素作用下导致的寰椎和枢椎解剖关系异常。外伤性寰枢椎骨折脱位是上颈椎损伤中较常见的一种,常累及延髓生命中枢与椎-基底动脉,导致患者瘫痪甚至死亡。本文报告1 例齿突骨折合并吁度寰椎后脱位不伴神经功能损伤的少见病例。     

Bisegmental rotational fracture dislocation of the pediatric cervical spine. A case report.

STUDY DESIGN: A case of a bisegmental rotational fracture dislocation in the pediatric cervical spine is presented. OBJECTIVES: To highlight the problems in the diagnostics and surgical management of this rare type of injury. SUMMARY OF BACKGROUND DATA: Fractures of the cervical spine are relatively uncommon in childhood. To the authors' knowledge, this is the first reported case of a bisegmental rotational fracture dislocation in the pediatric cervical spine managed by a combined anteroposterior approach. METHODS: A 6-year-old girl was hit by a car as a pedestrian. In addition to an open fracture dislocation of the Lisfranc joint in the right foot, she sustained a bisegmental fracture dislocation at the lower cervical spine (C3-C5) with no neurologic deficit. The complete diagnosis of a locked rotational fracture dislocation could be established only by using computed tomography scans with three-dimensional reconstructions. The injury was managed with a combined anteroposterior open reduction and a bisegmental anterior fusion. RESULTS: Implant removal was performed after bony fusion 6 months after surgery. At follow-up assessment 2.5 years later, the girl had a good radiologic result and a full and pain-free functional recovery. CONCLUSIONS: Bisegmental rotational fracture dislocations in pediatric cervical spines are not easily diagnosed and may require three-dimensional computed tomography scan reconstructions for complete assessment. In such rare cases, a combined anteroposterior surgical procedure may be indicated, with a bisegmental anterior fusion providing a good functional result.     

Bilateral facet dislocation on L4-L5 without neurologic deficit

We present a case of traumatic bilateral facet dislocation of L4-L5 without neurologic deficit in a 47-year-old woman after a motor vehicle accident. We considered that the mechanism of injury was the composition of hyperflexion, distraction, and rotation. Open reduction was easily performed when the obstacles consisting of the disrupted joint capsule and synovial membrane were completely removed. Also, posterior interbody and posterolateral fusion and pedicle screw augmentation are recommended because of surgeon familiarity, the absence of additional injury for unstable injury, and the safety of this treatment.     

Locked rotational dislocation of the cervical spine]

There is no generally accepted treatment protocol for dislocations of single articular processes of the cervical spine. However, the data in our own series and a survey of the literature show that in this type of injury the primary diagnosis rate is low (around 50%), that closed reduction maneuvers can be neurologically hazardous, and that operative fusion prevents certain complications. Among the 20 patients treated at the authors' institution the injury was located in the lower cervical spine in all but one patients and it was caused by a high-speed traffic accident in 14 patients. Four patients had no therapy at all; the others were fused by an anterior approach in 8, a dorsal approach in 6, and a combined method in 2 patients. There was one death due to intimal tearing of a vertebral artery. Closed reduction caused a transient neurological lesion in 2 patients. In 6 patients whose dislocation was neither reduced nor fused, 3 developed chronic instability. In our new treatment protocol dislocation of a single articular process is only reduced after a diskectomy to prevent extrusion of the disc. If reduction from the anterior approach fails or if it cannot be achieved due delayed treatment, the entrapped nerve root is decompressed. Fusion of the injured segments is carried out by bone blocks and plates or hooks.     

Transstyloid radiocarpal dislocation: A case report

Introduction and importanceTransstyloid radiocarpal dislocation is a rare injury. It is due to high-energy trauma. It usually associates a radiocarpal dislocation, a fracture of the radial and/or cubital styloid process, and a cortical volar/dorsal margin avulsion.Case presentationWe present a case of a 31-year-old male who sustained a fell from a 4 m height causing a transstyloid radiocarpal dislocation. He was treated with a radial styloid process pinning and wrist arthrorisis with and splint immobilization.Clinical discussionDifferent treatment options can be available for this type of injury with or without ligaments reconstruction.ConclusionAlthough it is rare, the transstyloid radiocarpal dislocation has a good outcome with different types of treatment.