合并椎体爆裂型骨折的颈椎过伸性损伤及其外科治疗

The hyperextension injury of cervical spine with bursting fracture and surgical treatment

目的探讨合并椎体爆裂型骨折的颈椎过伸性损伤的临床表现及治疗方法.方法对1996～2004年间收治的17例合并椎体爆裂型骨折的颈椎过伸性损伤患者损伤原因、机制,合并脊髓神经损伤的类型、程度以及手术治疗疗效进行分析.结果合并椎体爆裂型骨折的颈椎过伸性损伤常因高速撞击伤所致,损伤过程中发生了过伸性损伤转变为屈曲损伤,脊髓损伤严重.积极地行椎体切除减压、植骨融合重建颈椎稳定性的手术治疗效果满意.结论合并椎体爆裂型骨折的颈椎过伸性损伤是由于过伸应力转变为屈曲应力.及早解除机械性压迫因素,重建和保持颈椎稳定性是手术治疗的原则.

Objective To investigate the clinical manifestation of hyperextension injury of cervical spine with bursting fracture and the method of treatment. Methods Seventeen cases of hyperextension injury of cervical spine with bursting fracture from 1996 to 2004 were included in the data. The cause and mechanism of injury, type and extent of spinal cord injury, and the effect of surgical treatment were analyzed. Results Hyperextension injury of cervical spine with bursting fracture generally happened in the high-speed accident. There was a turnover of hyperextension injury to the flexion injury during the process. The injury of spinal cord was often serious. The therapeutic effect of the surgical group was much better than the conservative group. Decompression with corpectomy and stability reconstruction by fusion with graft was the effective surgical method. The result of surgical treatment was satisfactory. Conclusion The mechanism of hyperextension injury of cervical spine with bursting fracture is the turnover of hyperextension injury to flexion injury： The principle of surgical treatment is releasing the mechanical compression earlier, reconstructing and preserving the stability of cervical spine.