青少年疲劳性颈椎脱位与后凸畸形的诊断与治疗

Diagnosis and Treatment of Adolescent Fatigued Cervical Dislocation and Kyphosis

目的：探讨青少年疲劳性颈椎脱位与后凸畸形的诊断与治疗.方法：回顾性分析2002年3月-2009年3月本院治疗青少年疲劳性颈椎脱位与后凸畸形患者20例,其中寰枢椎半脱位1例,后凸畸形19例 保守治疗16例,手术治疗4例.结果：全部患者治疗后VAS评分均得到显著改善,由治疗前平均7.9分下降至治疗后1个月平均2.8分,最终随访平均1.2分.经平均24.1个月 （12～84个月） 随访,17例患者一期治愈（半年以上无复发） 另3例保守治疗者分别于治愈后6～17个月复发,其中2例再次牵引后支具固定而治愈,1例支具固定半年后治愈.结论：有长期低头学习、玩电脑游戏或工作病史的青少年,出现颈部疼痛不适、头痛头晕、恶心等症状,X线有颈椎失稳或畸形表现者,即可诊断 早期牵引等保守治疗有效,对症状严重牵引治疗无效者应积极手术治疗.

Objective：To investigate the diagnosis and treatment of adolescent fatigued cervical dislocation and kyphosis. Methods：20 patients with adolescent fatigued cervical dislocation and kyphosis in March 2003 to March 2009 were retrospectively analyzed. Among them, 1 case was atlantoaxial subluxation, 19 cases were kyphosis; 16 cases with non-operation and 4 cases with surgical treatment. Results：The VAS scores of all patients improved from 7.9 （ before the treatment） clown to 2.8 （ 1 month after operation）, and the last followup VAS score was 1. 2. After an average of 24. I months （12 months to 84 months） foilow- up, 17 patients were cured in one stage, 3 recurrences by non-operation, 2 of them were cured by traction with the brace fixation and 1 case was cured six months after the brace fixation. Conclusions：Adolescents who continue a long term of playing computer games or dropping heads will appear the symptoms of discomfort associated with head- ache, dizziness nausea and so on, with the help of X-ray, the manifestations of cervical spine instability or deformity can be diagnosed. Traction and other conservative treatment are effective at the early stage, patients with severe symptoms who can not be treated by traction should be actively and timely operated.