单纯前路复位内固定治疗无脊髓损伤合并关节突交锁的颈椎骨折脱位  

作　　者：徐天波[1] 刘德国[1] 范亮全[1] 顾江军[1] 郑隆宝[1] 

机构地区：[1]中国人民解放军第一一七医院骨三科,杭州310000

出　　处：《浙江临床医学》2018年第4期730-731,733,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨单纯前路手术治疗无脊髓损伤合并关节突交锁的颈椎骨折脱位的安全性及疗效。方法选取2013年6月至2016年12月就诊的无脊髓损伤合并关节突交锁的颈椎骨折脱位患者24例，采取单纯前路减压、撑开或撬拨复位技术治疗，记录手术相关指标，并评估手术疗效。结果24例患者手术完成时间59-93min，平均（83．2±5.9）min；出血量73-209ml，平均（947±63）ml，无输血患者。临床疗效评定中：2例患者获得良，22例患者获得优，优率91．67％。所有患者均获得随访，随访5～21个月，平均（11．2±4．3）个月。24例患者均无脊髓休克、脊髓受压或其他神经症状；术后出现一过性吞咽困难2例、声音嘶哑1例，治疗后恢复正常。结论I期前路减压、撑开或撬拨技术治疗无脊髓损伤合并关节突交锁的颈椎骨折脱住患者可达到解除关节突交锁并I期复位效果。Objective To explore the safety and efficacy of anterior reduction and internal fixation in treatment of no spinal injury lower cervical fracture-dislocation combined with facet locking through anterior approach. Methods 24 cases of no spinal injury lower cervical fracture-dislocation combined with facet locking through anterior approach were treated with anterior decompression alone, distraction or poking technology treatment. The amount of bleeding, operative time, postoperative neurological changes, fusion, dislocation correction, complications, etc were recorded during surgery and the surgery was assessed. Results The operation time of 24 patients was 59~93min, average was （ 83.2 ± 5.9 ） rain, the amount of bleeding was 73~209ml, the average was （ 94.7 ± 6.3 ） ml, without blood transfusion. In the evaluation ofchnical efficacy, 2 cases were good, 22 cases were superior, the rate of excellence was 91.67%. All patients were followed up for 5-21 months, with an average of （ 11.2 ± 4.3 ） months. None of the 24 patients had spinal cord shock, spinal cord compression or other neurological symptoms. There were 2 cases of transient dysphagia and 1 cases of hoarseness after operation, which returned to normal after treatment. Conclusion An anterior decompression, distraction or poking technology is an effective method for the treatment of patients without spinal cord injury combined with locked facet of cervical spine fracture and dislocation.

关 键 词：关节突交锁 颈椎脱位 前路手术 

分 类 号：R683.2[医药卫生—骨科学]