莫名肩頸痠痛、上肢麻 小心是「高位頸椎脫位」

<p style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”>今年48歲的洪先生在一次穿脫上衣時，突然聽到頸部發出「啵」的一聲，隨後感覺到肩頸痠痛，雙上肢感覺異常。剛開始以為是肌肉拉傷，接受復健治療卻遲遲未見療效，且症狀加劇，且曾出現下肢無力的症狀，於是至新竹臺大分院生醫醫院神經外科求診，經詳細神經學及影像檢查，診斷是第一節、第二節高位頸椎脫位，造成脊髓被壓迫，導致一系列症狀。</p>

<h3 style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”><strong>風濕關節炎&nbsp;</strong><strong>恐引起頸椎脫位</strong></h3>

<p style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”>陳蔚蔚醫師表示，第一節、第二節高位頸椎脫位屬於不穩定的脊椎狀態，除了脊髓被壓迫，會對神經造成短暫傷害，也有可能造成長期的神經損傷。症狀輕則只有肩頸痠痛、上肢發麻，嚴重則會導致四肢癱瘓，大小便困難，甚至造成呼吸衰竭，需要長期依賴呼吸器等，因此建議病人盡早手術處理。</p>

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<p style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”>陳蔚蔚醫師指出，造成第一節、第二節高位頸椎脫位的原因多樣，除了創傷，還有先天性疾病因素，以及自體免疫疾病等，其中風濕關節炎病患更是高位頸椎脫位的高風險族群。</p>

<h3 style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”><strong>高位頸椎手術　脫位頸椎復位</strong></h3>

<p style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”>醫學統計上有接近三成的機率會侵襲頸椎第一、二節的關節及韌帶，逐漸造成不穩定性的脫位及神經壓迫。部份病患在受傷初期，症狀輕微，容易被忽略。洪先生就是典型的例子，剛開始只有肩頸酸痛，上肢發麻，復健無效，症狀加劇，出現下肢無力，才驚覺不對勁。萬一被忽略，未正確尋求專業醫師協助，接受手術治療，後果可能不堪想像。</p>

<p style=”color: rgb(0, 0, 0); font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;”>洪先生在高階複合式手術室內接受這次高位頸椎手術（第一頸椎後減壓併第一/第二頸椎後固定及骨融合手術），換句話說，就是將原來脫位頸椎復位，再利用釘子及自體骨作內固定，達到穏定頸椎的療效。</p>