最近审阅: 24 十月 2020
最近更新: 20 八月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 复合损伤机制
  • 颈疼痛
  • 骶髓保留
  • 合并其他创伤性损伤
  • 颈椎后方压痛

其他诊断因素

  • 男性
  • 年龄18-25岁
  • 意识状态下降
  • 肢体麻木、刺痛或肌力下降
  • 直肠或膀胱功能障碍
  • 运动无力
  • 感觉缺失
  • 颈椎活动度(ROM)下降或活动时疼痛
  • 肛门直肠收缩或肛周感觉消失
  • 痉挛状态
  • 反射亢进
  • 巴宾斯基征
  • 霍夫曼征
  • 神经源性休克
  • 脊髓休克
  • 呼吸变化
  • 颅神经功能缺失

危险因素

  • 男性
  • 女性(颈椎挥鞭伤)
  • 缺乏准备或无意识状态下发生碰撞事故
  • 在发生碰撞事故时头部出现扭转
  • 颈椎损伤史或手术史
  • 之前有脊柱、头颅或其他发育性异常者

诊断性检查

首要检查

  • 颈椎轴位CT和三维重建
更多 首要检查

需考虑的检查

  • 颈椎X线检查
  • 颈椎 MRI
  • 过屈过伸位X线检查
  • 神经传导检查
  • 肌电图
更多 需考虑的检查

治疗流程

撰稿人

Christopher S. Ahuja

Research Fellow

Division of Neurosurgery

Department of Surgery

University of Toronto

Ontario

Canada

利益声明

CSA declares that he has no competing interests.

Michael G. Fehlings

Professor

Division of Neurosurgery

Director of Neuroscience Program

University of Toronto

Krembil Chair in Neural Repair and Regeneration

Medical Director

Krembil Neuroscience Center

Toronto Western Hospital

Ontario

Canada

利益声明

MGF served as a consultant for Zimmer, In Vivo Therapeutics, and Pfizer. He receives institutional fellowship grant support from AOSpine, Medtronic, and Depuy-Synthes. MGF is an author of a reference cited in this monograph.

Dr Christopher S. Ahuja and Dr Michael G. Fehlings would like to gratefully acknowledge Dr Narihito Nagoshi, Dr Hiroaki Nakashima, Dr David W. Cadotte, and Dr Jefferson R. Wilson, previous contributors to this monograph. NN, HN, DWC, and JRW declare that they have no competing interests.

同行评议者展开全部内容

Consultant Orthopaedic and Spinal Surgeon

BMI Werndale Hospital

Carmarthen

Carmarthenshire

UK

利益声明

JM has been provided with educational support for attending conferences by Medtronic, Depuy Spine UK, and Nuvasive.

Assistant Professor

Orthopedic Surgery Operations

Department of Orthopedics

University of Utah

Salt Lake City

UT

利益声明

AP is an author of a reference cited in this monograph.

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