前路选择性椎间隙减压植骨融合内固定术治疗颈椎过伸性损伤

Selective Fusion and Internal Fixation in Treatment of Patients with Hyperextension Injury of Cervical Spine

目的评价前路选择性椎间隙减压植骨融合内固定术治疗颈椎过伸性损伤的临床疗效。方法对27例颈椎过伸性损伤根据临床表现实施前路选择性椎间隙减压植骨融合内固定术,术后观察临床及影像学表现,定期评价神经功能。结果随访3～68个月(平均23.6个月),所有患者术后6个月摄颈椎X线正侧位片均提示骨性融合,无假关节形成,无钢板、螺钉松动及断裂等并发症,神经功能ASIA评分分别进行配对t检验,术后1个月与术前比较,脊髓运动功能和感觉功能均有明显恢复(P<0.01)。结论前路选择性椎间隙减压植骨融合内固定术治疗颈椎过伸性损伤可以减少患者的创伤,有效恢复神经功能,最大程度地保留患者颈椎运动功能,其是一种简单、安全的手术治疗方法。

Objective To study the effect of selective fusion and internal fixation in the treatment of the patients with hyperextension injury of cervical spine. Methods Twenty - seven cases of hyperextension injury of cervical spine were included in the data. They were treated with selective decompression, autograft fusion and internal fixation. The postoperative clinical and imaging manifestation and neurological function according to the ASIA were evaluated. Results All patient were followed up for 3- 68 months （mean 23.6 months）. All bone grafts obtained fusion in six months, without breakage or loosening of plates or screws breakage. The ASIA motor function and sensory function improved significantly from 31.78 and 69.52 preoperatively to 83.42 and 193.13 at the last follow- up. Conclusion The selective fusion and internal fixation in the treatment of the patients with hyperextension injury of cervical spine are safe and easy. It can diminish the injury to the patients and reserve neurological function and the motion function of the cervical spine as much as possible.