성인 경추부 척추분리증: 증례보고

초록

OBJECTIVE: We report a case of spondylolysis with an exceptional involvement of the cervical spine, and its management. METHOD A 20-year-old woman was referred with the diagnosis of unstable bipedicular fracture of C6. 2 years aog, she presented neck pain and both shoulder tingling sensation after minor trauma. There was no spinal cord syndrome. The standard x-rays and CT suggested a congenital or acquired anomaly with lysis of the pars interarticularis, spondylolisthesis, and spina bifida occulta at C6 RESULT Anterior interbody fusion C6-7 with Atlantis plate with iliac bone graft performed and the patient was symptom free after surgery. CONCLUSION Cervical spondylolysis is an exceptional anomaly. Diagnosis can be suspected on standard x-ray and is confirmed with CT. Congenital articular dysplasia is always found, but no argument has been put forward which would confirm that spondylolysis is itself a congenital rather than acquired stres lesion. The vast majority of patients can be treated with conservative measures.In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). The limits of exercise tolerance vary among the patientses and require the decision of the physician. Surgical intervention should be reserved for those who fail nonoperative management or who exhibit neurologic compromise. Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment.