颈椎骨折脱位合并单侧椎动脉损伤的手术治疗

Operation therapy in cervical vertebrae fracture and dislocation accompanying unilateral vertebral artery injury

目的探讨合并单侧椎动脉损伤的颈椎骨折脱位的手术治疗风险和临床效果。方法76例合并单侧椎动脉损伤的颈椎骨折脱位患者行前路减压、植骨融合内固定,其中颈椎脱位患者先试行闭合复位,不能复位者,先行后路切开复位,一期再行前路减压、植骨融合。结果76例患者均未出现健侧椎动脉损伤,术前神经功能正常者术后无一例出现神经损害症状,不全瘫患者术后均有不同程度恢复。结论合并单侧椎动脉损伤的颈椎骨折脱位进行合理的手术治疗具有良好的效果。

Objective To investigate the risk and the clinical effect of surgical treatment for cervical vertebrae fracture and dislocation with unilateral vertebral artery injury. Methods Seventy-six cases of the cervical vertebrae fracture and dislocation with unilateral vertebral artery injury were treated by anterior decompression, fusion and plate fixation. Reduction was firstly done by traction preoperative. Irreducible dislocation were treated by posterior operation before anterior decompression. Results There were no major complication. The cases without neurological lesion had no neurological signs after operation. Incomplete spinal cord lesion improved in different grade after surgery. Conclusion Surgical treatment is good for the cervical vertebrae fracture and dislocation with unilateral vertebral artery injury. But the surgical technique should be under careful decision.