颈椎创伤性单侧小关节脱位的前路手术复位与固定

Anterior reduction and immobilization for cervical vertebrae unilateral dislocations

目的 采用前路手术复位、固定治疗颈椎单侧小关节脱位 ,总结临床应用结果并探讨其理论依据。方法 回顾总结了 2 1例颈椎单侧小关节脱位病例 ,术前不作牵引复位 ,采取颈前路减压后撑开复位、植骨、前路带锁钢板内固定治疗。观察复位效果 ,结合术前、术后脊髓损伤ASIA评分比较手术疗效。结果 2 1例患者经手术证实有 9例合并创伤性颈椎间盘损伤(43% ) ,其中 5例为椎间盘脱出 (2 3% ) ,4例为单纯椎间盘碎裂伤 (2 0 % )。所有患者都获得成功复位 ,无手术相关的并发症发生 ,无神经损伤加重现象。随访 6～ 18月 ,效果满意 ,脊髓功能有改善 (P =0 0 12 )。结论 颈椎单侧小关节脱位时通常合并创伤性颈椎间盘损伤 ,采用前路减压、复位能提供安全。

Objective To evaluate the safety and efficacy of anterior reduction and immobilization for treating unilateral facet dislocation of the lower vertebrae cervical. Methods A retrospective review was made in 21 cervical injuries, identifying 21 unilateral facet dislocations before operation. All patients underwent anterior decompressive surgery, reduction of the dislocation, and stabilization of the vertebrae cervical. Results Based on intraoperative observation, 21 unilateral facet dislocations were identified. Incidenceof traumatic disc herniation was 43%(9/21). All dislocations were successfully reduced. No deterioration of neurological injury or operation associated complication were observed. Conclusion Greater attention should be placed on the association between cervical unilateral facet dislocation and traumatic disc herniation. Anterior operation is a safe and effective procedure for treatment of unilateral facet dislocation.