颈胸段脊柱骨折的外科治疗  

Characteristic and surgical treatment of cervicothoracic spine fracture

作　　者：郝定均[1] 贺宝荣[1] 吴起宁[1] 许正伟[1] 王晓东[1] 郭华[1] 昌震[1] 陈海波[1] 

机构地区：[1]西安市红十字会医院脊柱科,陕西西安710054

出　　处：《中国骨伤》2009年第8期580-582,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨颈胸段脊柱骨折合并脊髓损伤的临床特点以及治疗的效果。方法:1998年1月至2007年1月采用前路减压、植骨、Zephir钛板内固定治疗的颈胸段脊柱脊髓损伤患者38例,男29例,女9例;年龄18～58岁,平均36.4岁。所有患者均表现为颈胸部疼痛伴有颈胸部活动受限,局部压、叩痛。脊髓损伤按照ASIA分级:A级4例,B级13例,C级10例,D级7例,E级4例。结果:全部患者获随访,随访时间1～10年,平均4.5年,均获得骨性融合,融合时间为4～6个月,无螺钉松动、脱落及钢板断裂等并发症发生。神经功能恢复按AISA分级,平均改善3.8个级别。2例术后出现暂时性声音嘶哑,术后3～6个月恢复。7例Horner征患者术后症状消失。结论:颈胸段脊柱骨折并脊髓损伤表现复杂,前路减压、植骨、内固定可获得良好的治疗效果。Objective： To discuss the clinical characteristic and surgical treatment of cervicothoracic spine fracture complicated with spine cord injury. Methods：Thirty-eight patients with cervicothoracic fracture and spine cord injury were retrospectively analyzed from January 1998 to January 2007. There were 29 males and 9 females with an average age of 36.4 years ranging from 18 to 58 years. All patient suffered from pain and limitation of motion on cervicothoracic junction. According to American Spinal Injury Association （ASIA） grades,4 cases were in grade A, 13 cases in grade B, 10 cases in grade C,7 cases in grade D and 4 cases in grade E. All patients were treated with anterior decompressed,bone graft and Zephir plate fixation in cervicothoracic spine. Results：All patients were followed up for 1 to 10 years,the mean followed up time was 4.5 years. And all patients got complete bone fusion within 4 to 6 months postoperatively. There were no pull-out and breakage of screws or plates.Spinal cord functional recovery improved on average 3.8 degree according AISA standard. Two patients appeared transient hoarse voice after surgery, the symptoms were alleviated from 3 to 6 months after operation. Seven patients were complicated with Homer syndrome preoperatively, and the symptoms were disappeared after operation. Conclusion ：The clinical situation of cervicothoracic spine fracture with spine cord injury is complicated. And anterior decompressed,bone graft and internal fixation performed on cervicothoracic spine fracture can achieve an efficient and safe clinical outcome.

关 键 词：颈椎 胸椎 骨折 脊髓损伤 外科手术 骨折固定术 内 

分 类 号：R683.2[医药卫生—骨科学] R651.2[医药卫生—外科学]