前-后路联合手术治疗外伤性颈椎滑脱伴关节突交锁

Posterior-anterior Operation for Treatment of Traumatic Spondylolisthesis of Cervical Vertebra Combined with Facet Dislocation

目的探讨外伤性颈椎滑脱伴关节突交锁的手术方法及效果。方法收治外伤性颈椎滑脱伴关节突交锁22例,均行早期后路复位、Apofix或Vertex系统固定加植骨融合,同时一期行前路减压、自体骨植入融合加钛板内固定治疗。结果术后随访22例,时间6～48个月,平均24个月。患者全部获得椎间融合,无植骨块及钛板、螺钉松动,术后颈椎椎间高度、生理曲度无丢失。除全瘫者无神经功能恢复外,不全瘫者均有不同程度的恢复。结论外伤性颈椎滑脱伴关节突交锁患者早期施行前后路联合手术治疗,可获得满意疗效。

Objective To analyse the curative effect of posterior-anterior operation for traumatic spondylolisthesis of the cervical vertebra combined with facet dislocation. Methods Data of 22 patients with traumatic spondylolisthesis of the cervical vertebra combined with facet dislocation were included in the study. All patients were given early posterior operation for reduction. After reduction, the dislocation was fixated with Apofix or Vertex system, and fused with bone graft. After the position was changed to supine, all patients were treated with anterior cervical decompression, fusion of autogenous bone and internal fixation with titanium plate. Results Twenty-two patients were followed up for 6 to 48 months, average of 24 months. Interverbral fusion was observed in all patients. Neither slippage of grafted bone nor loosening of plate or screws occurred. There was no decrease of the cervical vertebral disc height and physiological curvature postoperatively. The paraplegia patients had no recovery of nervous function while the other patients had some recovery of nervous function postoperatively. Conclusion Early posterior-anterior operation is effective for patients with traumatic spondylolisthesis of the cervical vertebra combined with facet dislocation.