单纯前路手术治疗无明显后方压迫的陈旧性颈椎半脱位  

Single anterior approach surgery for old cervical spine subluxation

作　　者：赵必增[1] 袁文[2] 徐建广[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233 [2]第二军医大学长征医院骨科

出　　处：《中华创伤骨科杂志》2008年第8期730-733,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨无明显后方压迫的陈旧性颈椎半脱位行单纯前路手术减压内固定的可行性及手术方法。方法2004年5月至2006年7月收治陈旧性颈椎半脱位患者16例，受伤至手术时间均超过2个月，行前路减压，术中试图通过撑开螺钉及钛网钢板固定的运用，以获得减压固定、恢复正常序列。结果16例患者术后均恢复正常颈椎序列及椎间隙高度，随访6～11个月，平均8．5个月，无植骨未融合及钛板螺钉松动、断裂病例。所有患者症状均得到改善，JOA评分由术前的平均13．4分恢复为最后随访时平均15．9分，改善率为69．4％。结论对于陈旧性颈椎半脱位，后方结构已纤维愈合稳定，而且无明显后方脊髓压迫，前路减压技术完全能达到减压融合重建颈椎序列的目的。Objective To implore the feasibility of using single anterior approach surgery for old cervical spine subluxation. Methods From May 2004 to July 2006, 16 cases of old cervical spine subluxation underwent cervical spine surgery through anterior approach at least 2 months after injury. During operation, we managed to reconstruct the cervical vertebral body alignment through a special anterior approach decompression, application of retractor instrument, titanium mesh and plate manipulation. Results Follow-ups averaged 8.5 （6 to 11） months. The cervical vertebral body alignment was obtained in all the 16 cases. The osseous fusion was assured in all cases with no instrument failure. The JOA neurological scores were improved from 13.4 preoperatively to 15.9 postoperatively. Conclusion If there is no posterior compression and the posterior structure has a fibrous fusion, the single anterior approach is good enough for the old cervical spine subluxation to maintain alignment and obtain stability, and posterior reduction is not neeessary.

关 键 词：颈椎 脱位 内固定 前路手术 

分 类 号：R687.3[医药卫生—骨科学]