頸椎受傷之女性發生小面關節脫位與卡鎖後短期內自行復位：病例報告

Dislocation with Locking of the Bilateral Facet Joints Followed by Spontaneous Rapid Reduction in an Elderly Lady with Cervical Spine Injury: A Case Report

賴怡岑(Yih-Tsen Lai) ； 賴達明(Dar-Ming Lai) ； 梁蕙雯(Huey-Wen Liang)

《台灣復健醫學雜誌》 37卷2期 (2009/06) Pp. 139-145

https://doi.org/10.6315/2009.37(2)08

摘要

不同年齡族群發生頸椎損傷的好發病因不同，老年族群有較高比例因爲低能量傷害，比如跌倒而造成頸椎損傷。本文報告一位76歲女性，因從低處跌倒造成嚴重的第五、六節頸椎滑脫，還合併有雙側小面關節的卡鎖，在無施加外力下，三小時後的磁振造影顯示自動復位。病人在頸椎固定手術後轉至復健科病房進行復健治療，追蹤有神經學與功能上的明顯進步。本文將探討頸椎脫位的機制，小面關節卡鎖時可能造成的傷害，並探討復位可能的原因。本文亦討論臨床處置的注意事項，以及臨床預後追蹤的結果，以供參考。

關鍵字

小面關節脫位 ； 自動復位

並列摘要

The main causes of cervical spine injury vary among different age groups. Elderly people have a tendency to sustain injuries due to falls, which is a low energy mechanism of injury. Here, we report a case of a 76-year-old woman who fell down from sitting and suffered severe dislocation of the C5 on the C6 vertebra and locking of the bilateral facet joints. She showed spontaneous reduction of the dislocation on a magnetic resonance image taken 3 h after the injury. After surgical fixation of the dislocated cervical spine, she was transferred for rehabilitation therapy. Gradually neurological and functional improvement was observed postoperatively. In this paper, we present the clinical course, management and injury mechanism and also provide the discussions for the reasons of spontaneous reduction.

並列關鍵字

facet joints dislocation ； spontaneous reduction