儿童颈脊髓锐器伤一例

A case of stab wound of cervical spinal cord in a child

儿童颈脊髓锐器伤在临床中较为少见。我们报道一例4岁男童,在一次意外事件中被刀砍伤颈部后方,致使颈脊髓背侧损伤的病例。患者在急诊室表现为低血容量休克表现,经抗休克治疗,生命体征平稳后,行颈椎核磁共振显像显示C4水平部分脊髓背侧刀切伤伴周围脑脊液漏。急诊行颈椎后路清除血肿,止血并行硬膜囊修补缝合术。术后应用甲泼尼龙和营养神经药物。经随访14个月,患者神经受损完全恢复,但颈椎出现后凸畸形。

The stab wound of cervical spinal cord is rare in clinic. A four-year boy was encountered a directly posterior stab wound in neck by a knife in an accident. He was sent to hospital with hypovolemia shock. After treatment for hypovolemia shock MRI in cervical spine was performed which showed cervical spinal cord was partly cut from dorsal in C4.At the same time the leakage of cerebrospinal fluid was found near the cervical spine C4.He was treated with operation of decompression with local debridement and ligation hemostasis. After operation he received neuro nutrition drugs and Prednisolone because of neurologic deficit. A 14-month follow-up was made. His neurologic deficit was improved but deformity of cervical kyphosis appeared.