前路复位减压固定治疗下颈椎骨折脱位并脊髓损伤的效果分析  

Fusion for Cervical Fracture Dislocation with Spinal Cord Injury

作　　者：谢江[1] 姜飞[1] 王天堂[1] 陆江[1] 赫晓康 毛丰刚[1] 

机构地区：[1]阿克苏地区第一人民医院骨科,新疆阿克苏843000

出　　处：《新疆医学》2017年第10期1150-1153,共4页Xinjiang Medical Journal

摘　　要：目的探讨通过前路减压、复位、内固定术治疗下颈椎骨折脱位并脊髓损伤的治疗效果。方法回顾性分析2013年1月-2017年2月收治38例下颈椎骨折脱位并脊髓损伤的临床资料,按美国脊髓损伤ASIA分类标准:A级6例,B级15例,C级11例,D级6例。单侧关节突绞锁26例,双侧关节突绞锁12例;先行颅骨牵引闭合复位,维持局部稳定,后行前路颈椎体间撑开撬拨复位、减压、内固定治疗,并观察复位情况及治疗效果情况。结果本组病例均行前路减压、复位、内固定治疗,通过撬拨复位椎体,尽早解除脊髓压迫,恢复颈椎序列,且临床效果满意。术后按ASIA分类标准:A级3例,B级5例,C级13例,D级8例,E级9例。随访时影像资料提示:颈椎体间均骨性愈合,内固定钢板位置满意,无松动、断裂。结论颈前路减压、复位、内固定治疗下颈椎骨折脱位并脊髓损伤可以尽早复位椎体,解除脊髓压迫,临床效果满意。Objective To investigate the clinical efficiency with anterior cervical reduction and decompression and fusion for cervical fracture dislocation with spinal cord injury. Methods Clinical data of 38 patients suffering from lower cervical spine fracture dislocation with spinal cord injury admitted in our hospital from January 2013 to February 2017 were collected and retrospectively analyzed. There were 26 cases of unilateral facet interlocking and 12 cases of bilateral facet interlocking. Based on the nerve function according to ASIA classification criteria, including 6 cases of A type, 15 cases of B type, 11 cases of C type, and 6 cases of D type. All patients were given closed reduction with skull traction, failure reduction were opened operative reduction, and underwent anterior reduction and decompression and fusion fixation cage or damaged cervical corpectomy followed by titanium mesh implantation with bone titanium plate fixation. Results All patients with opened operative reduction were obtained complete reduction, with a successful rate of 100%, and were satisfied with the outcome. After surgery, ASIA classification criteria showed that 3 cases of type A and 5 cases of type B and 13 cases of type Cand 8 cases of type D and 9 cases of type E. No incidence was observed on the plate fixation with loosened and break.Conclusion Anterior cervical reduction and decompression and fusion for cervical fracture dislocation with spinal cord injury are relatively safe and effective treatment. It is satisfied with the clinic outcome.

关 键 词：下颈椎骨折脱位 椎间融合 钢板固定 

分 类 号：R683[医药卫生—骨科学]