下颈椎损伤分类系统和手术治疗策略

Classification system and surgical treatment strategy of subaxial cervical spine injury

下颈椎损伤发生率较高,在脊柱损伤中的发生率仅次于胸腰椎骨折。下颈椎解剖结构复杂,致伤机制多样,且由于损伤平面较高,致残率高,常给家庭及社会带来巨大的影响和经济负担。目前对下颈椎损伤的诊疗策略存在争议,如最新AO Spine分类系统是否更有利于治疗方案制定,急诊手术是否更有利于术后脊髓神经功能康复,前后联合入路适合哪些患者等。本文就下颈椎损伤分类系统、是否需手术治疗、手术时机及手术方式展开讨论。

Subaxial cervical spine injury has a high incidence which is only lower than the incidence of thoracolumbar injury.Subaxial cervical spine has complex anatomy structures and various injury mechanisms.Its injury commonly results in high disability rate and tremendous economic burden due to the high level of spinal cord injury.However,classification system,surgical timing and surgical strategies are still controversial in subaxial cervical spine injury.How to make the correct treatment strategy for subaxial cervical spine injury requires more focus.In this paper,classification system,necessity of surgery,surgical timing and surgical strategies are discussed.