下颈椎陈旧性脱位合并小关节损伤36例分析  

Treatment of chronic lower cervical spine dislocation with facet joint injury

作　　者：刘鹏[1] 孙庆[1] 王爽[2] 王兆麟[1] 程杰[1] 孙东[1] 秦廷正 孙长江[3] 

机构地区：[1]吉林大学中日联谊医院骨科,长春130033 [2]吉林大学中日联谊医院眼科,长春130033 [3]吉林大学中日联谊医院放射线科,长春130033

出　　处：《长春中医药大学学报》2015年第4期801-803,共3页Journal of Changchun University of Chinese Medicine

基　　金：吉林省科技发展计划项目"脊柱功能评价的临床研究"(20130206029SF);吉林省科技厅课题"TSP1在糖尿病视网膜病变中促进血管内皮细胞凋亡及ABT510抑制DR新生血管形成的研究"(20130522034JH)

摘　　要：目的探讨下颈椎陈旧性脱位合并小关节损伤的治疗策略与疗效。方法回顾性分析陈旧性颈椎小关节损伤患者36例,通过Frankel及JOA评分系统评价损伤程度和术后恢复情况。结果所有患者均行手术治疗,其中后入路椎弓根钉棒系统内固定7例,后-前-后联合入路椎弓根钉棒系统内固定4例,后路松解-前路融合内固定22例,前路融合内固定3例。随访6个月～2年,融合节段均获得骨性融合,无内固定松动断裂等并发症。Frankel评分术后改善1级34例,改善2级1例,无改善1例。JOA改善率0%～12.3%,平均8.3%。结论下颈椎陈旧性小关节损伤手术治疗的关键是后路对绞锁的关节突的松解及复位,前路的松解对复位有一定辅助作用。Objective To explore the treatment strategy of chronic lower cervical spine dislocation with facet joint injury. Methods Retrospectively review 36 cases of chronic lower cervical spine dislocation with facet joint injury,evaluating the injury and postoperative recovery condition by Frankel Grade and Clinical Symptom Score of the Japanese Orthopedic Association（ JOA scale）. Results All patients were treated operatively. 7 patients underwent posterior pedicle screw rod fixation,22 patients underwent posterior release and anterior fusion,3 patients underwent anterior cervical discectomy and fusion and 4 cases underwent posterior-anterior-posterior approach. The follow-up period was 6months to 2 years. In the follow up period,bone union was achieved in all patients and no fixation complication. Postoperatively the Frankel score improved 1 level of 34 cases,2 levels of 1 case,and 1 case no improvement. The JOA score recovery rate was 8. 3% on average（ range 0% ～ 12. 3%）. Conclusion key point for the reduction of the chronic lower cervical spine was facet joint release. Anterior release could contribute to the reduction.

关 键 词：下颈椎陈旧性损伤 颈椎骨折 颈椎脱位 手术策略 

分 类 号：R687.3[医药卫生—骨科学]