| 摘要: |
| ［摘要］ 目的 探讨下颈椎骨折脱位并脊髓损伤的手术入路选择及观察手术治疗的临床疗效。方法 对2005-01～2009-01 间68例下颈椎骨折脱位伴颈髓损伤患者进行手术治疗，前路减压复位植骨及颈椎带锁钛钢板固定51例，后路切开复位侧块钢板固定12例，前后路联合手术减压复位固定严重骨折脱位5例。结果 所有患者获得随访，时间6～28个月，平均11.8个月，植骨于3个月左右均获得骨性融合,颈椎椎间高度、生理曲度及颈椎稳定性维持良好，按Frankel分级，神经功能有3例无恢复，其余病例至少有1～3级以上的恢复或改善。结论 采用前路、后路或前后路联合入路手术治疗下颈椎骨折脱位均可使损伤节段获得早期稳定，根据颈椎损伤机理、损伤部位及类型采取适合的手术入路是手术成功的关键。 |
| 关键词: 下颈椎骨折 脊髓损伤 手术治疗 |
| DOI：10.3969/j.issn.1674-3806.2010.04.31 |
| 分类号:R 683.2 |
| 基金项目: |
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| Surgical treatment of fracture and dislocation of lower cervical spine with spinal cord injury :a clinical analysis of 68 cases |
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TAO Hai-nan, JIANG Shou-nian, FANG Gang, et al.
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Wuming County People′s Hospital of Nanning, Guangxi 530100,China
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| Abstract: |
| ［Abstract］ Objective To explore the choice of surgical approach and observe the clinical efficaly of surgical treatment in the fracture and dislocation of lower cervical spine and spinal cord injury.Methods From January 2005 to January 2009 68 cases of lower cervical spine fracture dislocation with cervical spinal cord injury were treated by surgical treatment: anterior decompression, reduction, bone graft and cervical spine locking titanium plate fixation in 51 cases; posterior lateral open reduction and blocking plate fixation in 12 cases; anterior-posterior decompression fixation for severe fracture-dislocation in 5 cases.Results All patients were followed up for 6-28 months, with an average of 11.8 months.Bone graft received bone fusion in 3 months or so, cervical intervertebral height and cervical lordosis and stability were excellently maintained, according to Frankel points grade, except 3 cases without neurological recovery,the restoration or improvement reached to at least 1-3 level and above in the remaining cases.Conclusion The anterior, posterior, or anterior-posterior approach for surgical treatment of lower cervical fracture dislocation may early make an injured segment into stable condition, taking the appropriate surgical approach according to cervical spine injury mechanism, injury location and type is the key to successful operation. |
| Key words: Lower cervical spine fractures Spinal cord injury Surgical treatment |
