在导航辅助下对一名多发性纤维发育不良患者进行枕颈固定和减压。

IF 1.4 Q2 OTORHINOLARYNGOLOGY
Yoshitaka Nagashima, Yusuke Nishimura, Takashi Abe, Ryuta Saito
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引用次数: 0

摘要

纤维发育不良(FD)是一种罕见的骨骼疾病,其特点是正常骨骼被纤维结缔组织取代,导致骨骼形成异常。本病例报告详细介绍了一名颅椎骨交界处纤维发育不良的 61 岁女性患者的成功治疗过程。该患者曾有颅内脑膜瘤病史,并已被诊断为 FD,在一次跌倒后出现步态障碍和肌肉无力。影像学检查显示,患者的颅骨和颈椎有广泛的多发性 FD 病变,C2 骨突骨折导致脊髓受压。患者接受了枕颈固定和减压手术。术中使用了 O 型臂导航,以确保准确放置螺钉和有效减压。该手术可以正确定位C2和C3椎弓根螺钉、切除增生的枕骨和C1后弓、放置枕骨钢板并避开囊肿组件。在两年的随访中,没有发现螺钉松动的迹象,患者的临床症状明显改善。该病例强调了量身定制的手术策略和先进导航技术在处理复杂 FD 病例,尤其是涉及 CVJ 的病例中的重要性。它还凸显了治疗多发性 FD 所面临的挑战,因为完全切除往往是不可行的。该病例的成功结果支持使用减压手术结合稳定术来缓解症状并预防进一步的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Navigation-assisted occipitocervical fixation and decompression in a patient with polyostotic fibrous dysplasia.

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by the replacement of normal bone with fibrous connective tissue, leading to abnormal bone formation. This case report details the successful treatment of a 61-year-old woman with FD at the craniovertebral junction (CVJ). The patient, who had a history of intracranial meningioma and had already been diagnosed with FD, experienced worsening gait disturbance and muscle weakness following a fall. Imaging studies revealed extensive polyostotic FD lesions in the skull and cervical spine, along with a C2 odontoid fracture causing spinal cord compression. The patient underwent occipitocervical fixation and decompression surgery. Intraoperative O-arm navigation was used to ensure accurate screw placement and effective decompression. This procedure allowed for proper positioning of the C2 and C3 pedicle screws, resection of the hyperplastic occipital bone and C1 posterior arch, and placement of the occipital plate with avoiding the cyst components. At a 2-year follow-up, there were no signs of screw loosening, and the patient showed marked clinical improvement. This case emphasizes the importance of tailored surgical strategies and the use of advanced navigational technologies in managing complex FD cases, particularly those involving the CVJ. It also highlights the challenges of treating polyostotic FD, where complete resection is often unfeasible. The successful outcome in this case supports the use of decompressive surgery combined with stabilization to relieve symptoms and prevent further complications.

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来源期刊
CiteScore
1.90
自引率
9.10%
发文量
57
审稿时长
12 weeks
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