Halo—vest支架复位联合前路减压内固定治疗下颈椎骨折脱位  

Halo-vest reduction combined with anterior decompression and internal fixation for lower cervical spine fracture and dislocation

作　　者：姚关锋[1] 王新家[1] 王伟东[1] 郑瑞武[1] 陈灵梓 

机构地区：[1]汕头大学医学院第二附属医院骨科,515041

出　　处：《中华创伤杂志》2015年第8期695-698,共4页Chinese Journal of Trauma

基　　金：高校博士点专项科研基金新教师类资助项目（20124402120004）;汕头大学医学院临床科研提升计划资助项目（201407）

摘　　要：目的探讨Halo—vest支架复位联合前路减压内固定治疗下颈椎骨折脱位的临床疗效。方法2009年1月-2012年12月采用Halo—vest支架复位联合前路减压融合内固定治疗下颈椎骨折脱位患者26例，其中男18例，女8例；年龄19～64岁，平均42．1岁。致伤原因：交通伤11例，高处坠落伤9例，重物压砸伤6例。骨折脱位部位：C5/610例，C6/79例，C3/44例，C4/53例。行Halo—vest支架复位后再行前路减压融合内固定术。比较术前、术后神经功能改善情况。结果术后随访24～36个月，平均27．4个月。末次随访X线片及CT示骨折脱位均复位良好、植骨融合，无内固定松动或断裂。按Frankel分级：术前A级6例，B级8例，C级7例，D级3例，E级2例；术后A级5例，B级3例，C级4例，D级5例，E级9例。神经功能改善显效（降低2级）6例，有效（降低1级）13例，无变化7例（P〈0．05）。结论Halo—vest支架复位联合前路减压内固定是安全可靠的治疗下颈椎骨折脱位的方法，值得临床推广。Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation. Methods From January 2009 to December 2012, 26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation. There were 18 males and 8 females, aged 19-64 years （mean, 42.1 years）. Injury resulted from traffic crashes in 11 cases, high falls in 9, and hit by heavy objects in 6. Segment of injury was C5/6in 10 cases, C6/7in 9, C3/4in 4, and C4/5in 3. Prior to anterior decompression/internal fixation and fusion, the Halo-vest external fixation was performed. Neurological performance was evaluated after operation. Results All the patients were followed up for 24-36 months （ mean, 27.4 months）. According to the X-ray films and CT scan at the final follow-up, the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening. Preoperative neurological status according to the Frankel grading was grade A in 6 cases, grade B in 8, grade C in 7, and grade E in 2. After operation, there were 5 cases in grade A, 3 in grade B, 4 in grade C, 5 in grade D, and 9 in grade E. All together, 6 cases presented two-grade improvement in neurological status, 13 one-grade improvement, and 5 no changes （ P 〈 0.05 ）. Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.

关 键 词：脊柱骨折 颈椎 外固定器 骨板 

分 类 号：R687.4[医药卫生—骨科学]