Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The incidence of traumatic spinal cord injury is 11,000 per year, with 55% of the injuries occurring between the age of 16 and 33, 18% of these in women of reproductive age. Diagnostic and early spinal decompression along with maintaining the mean arterial pressure to improve spinal cord perfusion and a high progesterone level in pregnancy for its neuroprotective and anti-inflammatory effect have the leading role in neurological recovery and clinical outcome.
We present a case of a patient in the 17th week of pregnancy who sustained luxation fracture of the C5 and C6 vertebrae and tetraplegia as passenger in a road accident. The early operative treatment and appropriate anesthetic procedure resulted in good clinical outcome with complete neurological recovery.Učestalost traumatskih ozljeda kralježnice je 11.000 na godinu, a 55% ozljeda nastaje u dobi od 16 do 33 godine, od toga 18% u žena reproduktivne dobi. Radiološka dijagnostika, uz ranu kiruršku dekompresiju kralježnice s održavanjem srednjeg arterijskog tlaka za očuvanje perfuzije leđne moždine, uz progesteron kao neuroprotektivni i protuupalni faktor u akutnoj traumi leđne moždine, ima vodeće mjesto u neurološkom oporavku i dobrom kliničkom ishodu. Donosimo prikaz slučaja trudnice u 17. tjednu trudnoće koja je zadobila luksacijsku frakturu petog i šestog vratnog kralješka s razvojem tetraplegije, kod koje su rano operacijsko liječenje i odgovarajući anesteziološki postupak doveli do dobrog kliničkog ishoda