无脊髓损伤的颈椎骨折脱位临床分析

CLINICAL ANALYSES OF CERVICAL FRACTURE-DISLOCATION WITHOUT SPINAL CORD INJURY

目的 探讨外伤性无脊髓损伤的颈椎骨折脱位的发病原因、机制及治疗方法。方法 对 9例外伤后颈椎骨折脱位者进行全面的影像学检查 ,通过临床症状及影像学改变分析颈椎骨折脱位的损伤机制 ,总结病变特点 ,提出治疗原则。 9例全部采用颈前路椎体复位术。结果 完全复位 8例 ,部分复位 1例。全部患者术后获得随访 1～ 3年 ,症状明显好转 2例 ,完全恢复 7例。未发现有神经症状加重 ,均可从事日常工作。结论 无脊髓损伤的颈椎骨折脱位 ,发病机制特殊 ,采用手术治疗颈椎固定稳定、脊髓致压因素去除彻底 。

Objective To investigate the etiology, pathological mechanism and treatment of cervical fracture dislocation without spinal cord injury. Methods Nine patients with cervical fracture dislocation without spinal cord injury were male and aged 22 to 63 years. Based on the clinical symptoms and roentgenographic changes, the injury mechanism was analyzed; and the pathological characteristics and treatment principle were put forward. Results Anterior reduction was employed in all 9 cases. Eight cases were reduced completely while 1 case was reduced partially. After following up 1 to 3 years, 7 cases recovered completely and the other 2 cases relieved their symptoms obviously. No nervous symptoms aggravated during the following up period. Conclusion Fracture dislocation of the cervical spine without spinal cord injury has special pathological mechanism. The surgical intervention is needed for solid fixation and complete decompression without any delayed neurosymptoms.