前路带锁钢板联合钛笼植骨融合术治疗下颈椎骨折脱位

Treatment of the Lower Cervical Spine Fracture Dislocation by Anterior Locking Plant and Titanium Cage Fusion with Bone Graft

目的评价前路带锁钢板系统结合钛笼内植骨融合治疗颈椎骨折脱位合并脊髓损伤的临床疗效及应用价值。方法对25例颈椎骨折脱位并脊髓损伤患者行颈椎前路减压、钛笼内植骨,纯钛带锁钢板内固定术,神经功能按JOA评分,于术前、术后1年余对所有病例均进行评分。结果 25例患者全部获得随访,平均随访时间15.5个月。骨折、脱位复位均满意,植骨于术后3个月融合,无钢板螺钉松动、断裂、钛笼陷入椎体内等并发症,术后1年JOA评分恢复率为(69.2±12.5)%。结论应用前路带锁钢板系统结合钛笼内植骨融合术治疗颈椎骨折脱位,能充分保证固定节段的稳定性,植骨融合率高,有效地维持了椎间高度和生理曲度,使脊髓在相对生理环境下达到最大程度的功能恢复,在颈髓损伤中有较大的应用价值,远期效果还有待于进一步观察。

Objective To evaluate the clinical curative effects and values of the treatment of cervical fracture and dislocation by anterior locking plate and titanium cage fusion with plate internal fixation. Methods Treat 25 cervical fracture and dislocation cases with anterior cervical decompression and anterior locking plate and titanium cage fusion with plate internal fixation. Rate for all cases accoding to ration of JOA before opration and 1 year later. Results 25 cases were all followed up for 15.5 months on average. All the bone grafts were fused within 3 months after the oper- ation and all the fraturm and dislocations were reduced gatisfyingly. There were no plate complication in any of the cases. The JOA grade improvement rates were （69.2~12.5）~ in 25 caes at 12 months postoperatively. Conclusion Stability of the fixed segments and high fusion can be achieved by applying anterior locking plates system for treat- ment of cervical vertebra injury ,combining with titanium cage interbody fusion. Moreover ,the treatments allows both the height of intervertebral disccan and physiological curvature to be maintained,which in turn results in the restoration of the spinal cord in a relatively physiological conditions. The treatments would play an important role in the cervical spinal cord injury. Also,the long-term effect remains to be luther investigated.