RESUMO
A 41-year-old female presented with a rare case of bilateral vertebral artery occlusion following C5-6 cervical spine subluxation after a fall of 30 feet. Digital subtraction angiography showed occlusion of the bilateral vertebral arteries. Unlocking of the facet joint, posterior wiring with iliac crest grafting, and anterior fusion were performed. The patient died on the 3rd day after the operation. This type of injury has a grim prognosis with less than a third of the patients achieving a good outcome.
Assuntos
Vértebras Cervicais/lesões , Artéria Vertebral/lesões , Insuficiência Vertebrobasilar/diagnóstico por imagem , Insuficiência Vertebrobasilar/etiologia , Ferimentos não Penetrantes/complicações , Adulto , Angiografia Digital , Transtornos Cerebrovasculares/fisiopatologia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Evolução Fatal , Feminino , Parada Cardíaca/etiologia , Humanos , Tomografia Computadorizada por Raios X , Tração/métodos , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/cirurgia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/cirurgiaRESUMO
Eosinophilic granuloma of bone is the localised and most benign form of Langerhans-cell histiocytosis, previously known as histiocytosis X and is characterised by lytic lesions of one or more bones. It is a disease of children and adolescents, and very rarely affects adults. We report a 34-year-old patient with a solitary eosinophilic granuloma involving the fifth lumbar vertebra which produced sciatica. Operative treatment performed by a single extended posterior approach consisted of total resection of the tumour with hemicorporectomy, L4-5 and L5-S1 discectomy, interbody fusion with an iliac bone graft, and interpedicular fixation. Postoperatively, the symptoms resolved and the patient continues to do well at 2 1/2 years follow-up.