急性下颈椎交锁型和水平脱位并脊髓损伤

Acute Interlocking and Horizontal Dislocations of Lower Cervical Spine Complicated with Spinal Cord Injury

目的探讨急性颈椎交锁和水平脱位并脊髓损伤的治疗方法。方法采用徒手复位和牵引相结合的方法治疗急性下颈椎交锁脱位、水平脱位伴骨折，并有不同程度脊髓和神经根受压损伤１５例病人。结果本组治疗１３例得到６～１８月的随访，平均１１月。有１２例脊柱稳定，无继发性滑脱，无显性脊柱退变和迟发脊髓损伤。脊髓和神经根恢复分优者４例、良者６例、可者２例、差者１例；优良率达８０％。结论急性下颈椎交锁及水平脱位，临床可以通过徒手复位和牵引相结合的方法，达到理想复位。结合脱水剂、微血管扩张剂、糖皮质激素和神经介质等药物应用，促进脊髓神经组织恢复。

Objective To study the methods for treating acute interlocking dislocation and horizontal dislocation of lower cervical spine complicated with spinal cord injury.Methods The combination of manipulative reduction and traction was applied for treating 15 cases of acute lower cervical spine dislocations complicated with compressive injury of spinal cord and nerve roots in different extent.Results 13 cases were followed up for 6 to 8 months.Among them,there were 12 cases with stable spine,and without seconary spondylolisthesis,prominent degeneration and delayed spinal cord injury.As to the recovery of spinal cord and nerves,there were 4 cases in excellent grade,6 good,2 passable and 1 bad.The excellent and good rate was 80%.Conclusion The ideal recovery of acute interlocking dislocation and horizontal dislocation of lower cervical spine can be achieved with the combination of manipulative reduction and traction.The combined application of osmotic diuretic,glucocorticoid,vasodilator, and neurotransmitter can promote the recovery of nervous tissue in spinal cord.