完全四肢麻痺より回復したC4 anterior dislocationの1手術症例

A Case of Traumatic Anterior Dislocation of C4 Recovered from Complete Tetraplegia

I．はじめに

　急性脊髄損傷の手術適応は古くから論議の多い課題であるが，われわれは，完全四肢麻痺より回復した第4頸椎前方脱臼の1手術症例を経験したので，文献的考察を加えて報告する．

　A case of traumatic anterior dislocation of C₄ is presented.

　A 65-year-old man who was beastly drunken fell down backward and severely struck occipital region against the door and immediately developed tetraplegia. Neurological examination 12 hours after the trauma revealed complete flaccid tetraplegia, abdominal respiration, bladderbowel disturbance, anesthesia below C₅ and hyperpathia in C₃ and C₄ dermatomes. Plain films of the cervical spine disclosed anterior dislocation of C₄ upon C₅ approximately 6 mm and possible disc herniation of C_4/5.