下位颈椎骨折脱位合并关节突绞锁骨折的早期手术治疗  

Early operative treatment of the fracture-dislocation of infra-cervical vertebra combine with articular process interlocking or fracture

作　　者：刘景臣[1] 高中礼[1] 刘光耀[1] 施建胜[1] 黑发志[2] 

机构地区：[1]吉林大学中日联谊医院骨科,吉林长春130031 [2]吉林大学前卫医院

出　　处：《中国骨伤》2003年第6期326-328,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨一种早期经后路切开复位完成下位颈椎稳定手术的方法 ,以解决合并关节突绞锁、骨折的颈椎骨折、脱位复位的问题。方法　 14例合并关节突绞锁、骨折的颈椎骨折、脱位病人 ,其中 6例前后路手术一次完成 ,后路手术切开复位 ,前路椎间植骨 ,钛合金自锁钢板 (CSLP)内固定 ;其余 8例先行后路切开复位、棘突间钢丝内固定 ,择期行前路椎间植骨融合术。结果　 14例脱位颈椎全部达到解剖复位 ,使脊髓受压迫状态解除 ,神经功能按Frankel分级均提高 1～ 2级。结论　合并关节突绞锁、骨折的颈椎骨折、脱位早期切开复位是可行的 ,对解除脊髓的压迫状态 ,挽救脊髓残留的神经功能 。Objective To explore an operative treatment for the fracture or dislocation of cervical spine complicated with articular process interlocking or fracture [HT5”H]Methods [HT5”SS]14 cases of fracture or dislocation of cervical spine complicated with articular process interlocking or fracture were treated,6 cases of them underwent the posterior approach open reduction and the anterior approach operation of bone implanting and internal fixation by CSLP at the same time.For the other 8 cases whose health condition were not well enough,we performed open reduction posteriorly and internal fixation by steel wire between spinous process at first,and intervertebrae fusion anteriorly with implanted bone was done later.[HT5”H]Results [HT5”SS]All 14 cases of the fracture or dislocation of cervical spine were reduced perfectly and spinal cord compression were relieved.The neural function recovered 1 to 2 levels according to the Frankel classification.[HT5”H]Conclusion [HT5”SS]The results showed that early open reduction for cervical fracture or dislocation complicated with articular process interlocking or dislocation is possible,which can relieve compression and remedy neural function of spinal cord.

关 键 词：下位颈椎骨折 下位颈椎脱位 合并症 关节突绞锁 关节突骨折 早期 手术治疗 

分 类 号：R683.2[医药卫生—骨科学] R684.7[医药卫生—外科学]