上颈椎骨折的非手术治疗:5年经验总结  

Conservative treatment for upper cervical spine fractures:5 years' experiences from a single institute

作　　者：殷翔[1] 刘鹏[1] 范伟力[1] 柳峰[1] 陈波[1] 赵建华[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所脊柱外科,重庆400042

出　　处：《创伤外科杂志》2012年第2期120-122,共3页Journal of Traumatic Surgery

摘　　要：目的探讨采用非手术治疗上颈椎骨折的适应证并观察其疗效。方法检索我科近5年收治的44例上颈椎创伤患者病例资料,其中29例接受了非手术治疗,包括寰椎骨折6例,Hangman骨折7例(Ⅰ型4例,Ⅱ型3例),齿状突骨折14例(Ⅱ型4例,Ⅲ型10例),枢椎侧块骨折1例,枢椎体粉碎性骨折1例。采用的非手术治疗方法如下:Halo-vest支架固定14例,颈托固定4例,头颈胸支具固定11例。结果27例患者获得完整随访资料,2例失访,随访时间4～45个月。末次随访均可见骨折处愈合,未见寰枢关节不稳表现。结论采取适宜的非手术方法治疗上颈椎稳定性骨折,可取得较好的临床疗效。手术仅在寰枢关节稳定性遭到破坏且无法通过非手术治疗恢复时才必须实施。Objective To explore the indications and curative effect of conservative treatment for the upper cervical spine fractures.Methods Data of 44 cases of upper cervical injuries were reviewed,29 of whom were performed conservative treatment,including 6 cases of atlas fractures,7 cases of Hangman fractures,14 cases of odontoid bone fractures,1 case fracture of left lateral mass of axis,1 case of burst fracture of axis.Ptients with conservative treatment were treated with Halo-vest in 14 cases,cervical support in 4 cases,cervicothoracic orthosis in 11 cases.Results The complete follow-up data of 27 cases were obtained.The follow-up time ranged from 4 to 45 months.All patients showed a solid bony fusion with no atlantoaxial instability.Conclusion Suitable conservative therapy is an effective way for treating upper cervical spine fractures.And surgery should be performed in specific cases with atlantoaxial instability,which can＇t be solved by conservative treatment.

关 键 词：颈椎骨折 非手术治疗 适应证 

分 类 号：R681.55[医药卫生—骨科学]