摘要
目的 探讨陈旧性下颈椎骨折脱位手术治疗的意义和术式选择。方法 1 996年 7月至 2 0 0 3年 3月 ,我们对 2 4例陈旧性下颈椎骨折脱位并脊髓损伤的病人进行了手术治疗 ,行前路减压复位植骨 1 6例 ,其中 1 3例应用前路钢板固定 ;后路侧块钉板固定 5例 ;前后联合入路内固定 3例。结果 随访时间平均 1 8个月 ,所有植骨均获得愈合 ,不完全脊髓损伤患者功能恢复按Frankel评分平均提高 1 .4级 ,所有神经根刺激症状恢复 ,无严重并发症的发生。结论 颈椎损伤早期治疗十分重要 ,陈旧性颈椎骨折脱位手术治疗仍然有效 ,术式的选择应根据减压、复位及稳定性重建的需要综合评估而定 ,包括前路。
Objective To investigate the value of surgical treatment of old lower cervical fractures and dislocations and the selections of operational approaches.Methods From July 1996.to march 2003,24 cases of old lower cervical fractures and dislocations were treated surgically.16 cases were operated with anterior decompression,reduction,auto-illac graft fusion,among which 13 cases were applied with anterior locking plate systems,5 cases by posterior approch and lateral mass screws and plate system,and 3 cases by combination of anterior and posterior internal fixation.Results With an average of 18 months follow-up,all cases obtained solid fusion without severe neurovascular complications.Patients with incomplete spinal cord injury have an improvement of an average of 1.4 Frankel level.All sustained nerve root functions fully recovered at the time of follow up.Conclusion Rational treatment at the early stage for the cervical spine injury is very important.Surgical treatment of the old lower cervical fractures and dislocations remains to be evaluable,and the selection for approaches should be based on comprehensive accessment of the need of neurological decompression,reduction and reconstructional stabilization,including anterior,posterior and combing the both approaches.
出处
《实用骨科杂志》
2004年第1期1-4,共4页
Journal of Practical Orthopaedics
