Halo-vest在重建上颈椎稳定性中的应用  

APPLICATION OF HALO-VEST IN STABLE RECONSTRUCTION OF UNSTABLE UPPER CERVICAL SPINE

作　　者：王吉兴[1] 金大地[1] 姚军[1] 陈建庭[1] 江建明[1] 瞿东滨[1] 

机构地区：[1]第一军医大学附属南方医院脊柱骨病外科,广州510515

出　　处：《中国修复重建外科杂志》2004年第5期399-401,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　评价应用 Halo- vest在重建上颈椎稳定性中的疗效。　方法　总结 1997年 3月～ 2 0 0 2年 10月收治上颈椎疾患 16例 ,年龄 14～ 5 3岁。单纯 Jefferson骨折 3例 ,单纯 Hangman骨折 4例 ,Anderson 型骨折 1例 ,以上均采用 Halo- vest固定 3～ 4个半月。齿状突陈旧性骨折伴脱位行枕颈融合内固定术 3例 ,C2、3椎体结核病灶清除植骨融合术 1例 ,C1 恶性肿瘤行后路肿瘤切除枕颈内固定 1例 ,C2 恶性肿瘤行前路肿瘤切除植骨内固定 2例 ,颈椎管肿瘤行C2～ 7全椎板切除术后鹅颈畸形行前路脊髓减压植骨螺钉内固定 1例 ,以上均采用 Halo- vest术中固定 ,其中 2例术后继续应用 3个月。 16例中有脊髓功能障碍者 8例。　结果　术后 15例获 6个月～ 5年随访。其中 1例 Jefferson骨折后弓愈合 ,前弓未愈合 ,拆除支架后未出现不适 ,颈椎活动正常 ;1例 C2 肿瘤术后 8个月复发 ;其余均得到骨性愈合。 8例脊髓功能障碍者术后均恢复正常。　结论　 Halo- vest对上颈椎失稳的固定效果可靠 ,可用于术前、术中和术后的上颈椎稳定性重建 。Objective To evaluate the clinical effect of Halo vest in treatment of unstable upper cervical spine. Methods From March 1997 to October 2002, 16 cases of unstable upper cervical spines were treated and immobilized by Halo vest, aged from 14 to 53 years. There were 3 cases of isolated Jefferson fractures, 4 cases of isolated Hangman fractures and 1 case of Anderson type Ⅱ fracture. The 8 cases were immobilized for 3 4 months by Halo vest. There were 3 cases of old odontoid fractures with dislocations treated by occipitocervical plate fixation and fusion, 1 case of C 1 malignant tumor by posterior resection and internal fixation, 2 cases of C 2 malignant tumor by anterior resection, fusion, and internal fixation; these cases were immobilized by Halo vest during surgery. There were 1 case of C 2,3 tuberculosis were treated by anterior debridement and fusion, and 1 case of gooseneck deformity by anterior decompression, fusion and screw fixation after resection of C 2 7 , the 2 cases were immobilized for 3 months by Halo vest.Of 16 cases, there were 8 cases accompanied with spinal cord syndrome. Results Fifteen cases were followed up 6 months to 5 years. Anterior arch ununion and posterior arch osseous healing occurred in 1 case of Jefferson fracture. Other fractures and embedded bones became osseous fusion. One case of C 2 malignant tumor recurred 8 months after operation. Spinal cord syndrome of all patients disappeared. Conclusion Halo vest immobilization is an effective method for conservative treatment and stable reconstruction of unstable upper cervical spine.

关 键 词：上颈椎 术后 肿瘤切除 脊髓功能 前路 JEFFERSON骨折 正常 恢复 畸形 活动 

分 类 号：R687.3[医药卫生—骨科学]