颈椎骨折伴双侧关节突绞锁的临床治疗研究

Study the Treatment of Cervical Vertebrae Fracture Combined with Bilateral Articular Process Interlocking

目的探讨一期后前联合入路治疗难复位型颈椎骨折伴双侧关节突绞锁的临床诊治效果。方法将作者医院2014-01/2016-12收治的颈椎骨折伴双侧关节突绞锁损伤患者9例纳入本研究,术前脊髓损伤Frankle分级:A级2例,B级4例,C级3例。术后定期随访,通过影像学检查了解节段稳定性、植骨融合情况,比较患者手术后前Frankle分级变化。结果 9例共随访12个月。术后影像学检查显示复位效果满意,颈椎椎间高度及生理曲度维持良好,植骨全部融合,无钢板螺钉并发症;除术前Frankle分级A级的2例患者神经功能有1～2级恢复,其余7例神经功能均有2～3级的恢复。结论一期后前联合入路治疗难复位型颈椎骨折伴关节突绞锁可以获得满意的临床效果。

Objective To explore the clinical effects of one-stage anteroposterior approach in treating cervical vertebrae fracture combined with bilateral articular process interlocking. Methods A total of 9 cases of cervical vertebrae fracture combined with bilateral articular process interlocking in authors’ hospital from January 2014 to December 2016 were enrolled. The Frankle grading system for preoperative showed that 2 cases were of grade A,4 cases were of grade B and3 cases were of grade C. The segmental stability and bone graft fusion were evaluated through the postoperative radiographic examinations, and compared the change of the Frankle grading before and after operation. Results All patients were followed up for 12 months. The effect of restoration was satisfactory. The cervical intervertebral height and curvature of spine were maintained normal, bone fusion was achieved,and no plate ande screw related complications were observed. Grade 2 to 3 neurological recovery were 7 cases, while grade 1 to 2 neurological recovery were 2 cases of grade A.Conclusion One-stage anteroposterior approach has a satisfactory clinical effect in treating cervical vertebrae fracture combined with bilateral articular process interlocking.