前路手术治疗Ⅱ型创伤性枢椎滑脱  

Anterior surgical treatment of type Ⅱ traumatic spondylolisthesis of the axis

作　　者：吴琼华[1] 陈维善[1] 陈其昕[1] 徐侃[1] 李方财[1] 

机构地区：[1]浙江大学医学院附属第二医院骨科,杭州310009

出　　处：《中华创伤杂志》2009年第5期399-402,共4页Chinese Journal of Trauma

摘　　要：目的评价Ⅱ型创伤性枢椎滑脱前路手术的疗效。方法本组27例Ⅱ型创伤性枢椎滑脱，其中男19例，女8例；年龄22～67岁，平均38岁。4例有脊髓损害患者按Frankel评级为D级。采用前路C2-3，椎间盘切除，椎体间植骨和钢板固定。结果手术时间平均86min（75～95min），失血量平均135ml（100～160ml），住院时间平均10．8d（9～12d）。平均随访时间14个月（9～24个月），术后3个月所有患者均获骨性融合，无椎体移位和成角畸形。颈椎活动度满意，无一例出现慢性颈痛。结论前路手术创伤小，术后恢复快，住院时间短。前路C2-3椎间盘切除、椎体间植骨融合治疗Ⅱ型创伤性枢椎滑脱是简便、安全和有效的方法。Objective To evaluate the clinical efficacy of anterior C2-3 discectomy and fusion in treatment of type il traumatic spondylolisthesis of the axis. Methods A total of 27 patients with type Ⅱ traumatic spondylolisthesis of the axis were treated with anterior C2-3 discectomy, fusion and plate fixation. There were 19 males and 8 females, at average age of 38 years （22-67 years）. The spinal cord function was at Frankel D in four patients. Results Operation lasted for 75-95 minutes （ mean 86 minutes） , with blood loss of 100-160 rnl （mean 135 ml）. Hospital stay was 9-12 days （mean 10.8 days）. Follow-up for 9-24 months （mean 14 months） showed that all patients achieved bony fusion within three months postoperatively, with no anterior displacement or kyphosis. The range of cervical movement was normal, with no chronic neck pain ocurred. Conclusions Anterior approach can minimize surgical trauma, shorten recovery time and hospital stay. Anterior C23 discectomy and fusion is a feasible and safe surgical technique and can get satisfactory therapeutic effect in treating type Ⅱ traumatic spondylolisthesis of the axis.

关 键 词：脊柱损伤 脊柱融合 外科手术 

分 类 号：R687.3[医药卫生—骨科学]