颈椎关节突交锁的诊断与外科治疗

Diagnosis and Surgical Management of Locked Facet of Cervical Spine

本文报告从1988年12月至1994年12月诊治的14例陈旧性颈椎关节突交锁患者,受伤至入院时间平均3.9个月(1～1O个月).脱位节段:C_(3～4)2例,C_(4～5)例,C_(5～6)例,C_(6～7)例.单侧脱位9例,双侧脱位5例.本组患者均有被误诊、误治的病史.在交锁关节突切除.脱位节段植骨融合的基础上,分别采用4种复位固定方法.术后随访平均2年8个月(6个月～5年3个月),9例患者中有7例神经症状有不同程度的改善.本文还对该病的诊断要点,误诊误治原因及目前的处理观点等问题作了讨论.

The diagonosis and surgical management of 14 patients suffering from old facet dislocation of cervical spine from December 1988 to December 1994 were reported. The duration from wounded to admitted to our hospital was averaged 3. 9 months (ranged from 1 to 10 months). Dislocation levels were as follows; C3-1in 2 cases; C1-5in 4 cases; C5-6in 5 cases and C6-7-in 3 cases. Unilateral locked facet were in 9 cases and bilateral locked facet were in 5 cases. All patients had the history of misdiagnosis and wrong treatment. On the base of facetectomy and iliac bone grafting, four kinds of treatments were used. Nine patients were followed up averaged 2 years and 8 months (ranged from 6 months to 5 years and 3 months). The neurological symptoms of 7 patients were relieved in different degree. In this paper, the key points of diagnosis, the reasons of misdiagnosis and wrong treatment and the update surgical treatment were discussed.