前路复位内固定治疗难复性下颈椎脱位

Anterior open reduction and internal fixation to treat the lower cervical irreducible dislocation

目的探讨前路手术治疗难复性颈椎骨折脱位的可行性。方法采用前入路手术方式治疗15例下颈椎脱位病例，其中男11例，女4例；MRI及CT扫描证实存在单侧关节交锁10例，双侧关节交锁5例；15例患者经颅骨牵引未见复位，选择单一前路手术复位前路钢板内固定、椎间融合术。结果15例均得到完，全复位，未见神经症状加重。结论前路复位内固定术治疗颈椎脱位效果良好。

Objective To explore the possibility of anterior open reduction and internal fixation to treat the lower cervical irreducible dislocation. Methods 15 cases of lower cervical irreducible dislocation were treated by the anterior open reduction and internal fixation, 11 cases were male and 4 cases were female, 10 cases were unilateral facet locked and 5 cases were bilateral facet locked which were confirmed by the MRI and CT scan. All the cases were failed to the skull traction before operation and received anterior open reduction and plate fixation, and intervertcbral fusion. All the cases were followed up, the recovery of neurological function and the fusion rate were evaluated. Results 15 cases were completely reduction and none of them got a worse neurological function. Conclusion The treatment effect of anterior open reduction and fixation for the lower cervical irreducible dislocation were good.