单纯前路手术治疗下颈椎脱位

Single anterior approach surgery for lower cervical spine dislocation

目的探讨早期单纯前路手术治疗下颈椎脱位的临床疗效;方法对2005-06-2011-08收治的41例下颈椎脱位患者,采用颅骨牵引下复位或术中复位,单纯行前路减压,钛网或自体髂骨块植骨融合,前路钢板固定治疗。结果所有病例均得到良好复位,根据X线片定期检查结果,颈椎生理弧度及椎间隙高度良好,植骨融合确切,未出现内固定失用。术后随访10~28个月,Frankel分级显示,绝大部分患者术后神经功能得到不同程度的改善;结论早期行单纯前路手术治疗下颈椎脱位,可获得良好的解剖学复位,能有效地解除脊髓压迫,使脊柱获得即刻稳定。

Objective To investigate the clinical effect of early anterior operation for the treal- ment of lower cervical dislocation. Methods From June 2005 to August 2011,a total of 41 pa- tlents who suffered from lower eervica] dislocation, underwent single anterior surgery of decompres- sion and plate fixation with autograft or titanie net after reduction by skull traction or reduction during the surgery. Results After operation,all the patients had good reduction. The postoperative X-ray results showed that the inte^wertehral height and the physiologic spinal curve were kept well, and solid fllsion was obtained. There were no pull-out and breakage of screws or plates. The pa- lients were followed up for 10-28 months, the neurological functions of most patients were ira- proved according to the Frankel classification. Conclusion Single anterior approach surgery for lower cervical spine dislocation in the early phase can result in good anatomical reduction with less trauma, effectual decompression,and satisfying immediate stability of the cervical spine.