非融合手术治疗上颈椎骨折的临床分析

Non-fusion operation for A upper cervical fracture

目的探讨非融合手术治疗上颈椎骨折的可行性。方法我科自2000年3月-2007年8月选择性非融合手术治疗上颈椎骨折26例,所有患者入院后即予颅骨牵引,完善术前准备后分别行后路Apofix、Vertex固定术,术中保留小关节的完整性,骨折愈合后取出内固定。取出内固定后分别于4周,12周及24周评价颈椎运动功能。结果术中未出现脊髓损伤及椎动脉破裂等并发症。25例内固定取出后随访10～26个月(平均18月),颈椎生理功能为优者11例,良9例,可2例,差3例,优良率80%。结论选择性地采用非融合手术治疗上颈椎骨折,在重建稳定的同时可以保留上颈椎良好的活动功能。

Objective To investigate the feasibility of the upper cervical spine fracture treated with non-fusion surgery.Methods Before operation all 26 cases were performed skull traction from March 2000 to August 2007.Posterior approach were performed and cervical spine were fixed with Apofix or Vertex while the integrity of the facet were protected carefully.After the bone union,all fixation were removed.After 4 weeks,12 week and 24 week from removing fixation,cervical function were evaluated.Resultes No serious complications occurred among and after operation.25 of 26 cases（1 missed followed up） were followed up from 10～26 months（average 18 months）,cervical spine physiology functional score were excellent in 11 cases,good in 9 cases,fair in 2 cases,difference in 3 cases.Conclusion Upper cervical physiological activity can be reserved as far as possible after non-fusion operation.