【摘要】 目的:探讨采用联合入路内固定治疗严重下颈椎骨折脱位的临床疗效。方法:本组31例严重下颈椎骨折脱位患者,采用前后联合入路,前路行减压、植骨、内固定;后路12例行颈椎椎弓根钉棒系统固定,18例行侧块螺钉钉棒系统固定,1例行棘突间钢丝捆绑固定,术后定期行X线片检查观察损伤节段的融合情况,以Frankle分级判定脊髓功能恢复情况。结果:1例患者术后因脊髓损伤平面上升导致呼吸衰竭死亡,2例术后失访,余28例患者获得随访12～18个月,平均14个月,4例术前Frankel分级A级无恢复外,其余患者均有不同程度恢复,脊髓功能平均提高1.1级,术后4～6个摄片融合节段均获得骨性融合。结论:采用联合入路手术治疗严重下颈椎骨折脱位复位可靠、减压充分、增加颈椎的稳定性,方便术后的护理和功能锻炼,减少了长期卧床的并发症,是治疗严重下颈椎骨折脱位的有效方法。更多还原

【Abstract】 Objective To evaluate the clinical results of Combine approach for the treatment of severe lower cervical spine fracture and dislocation.Method 36 patients were treated by combined anterior-posterior operative method,and used anterior operative method,decompression、bone graft and internal fixation.To the operative method of posterior,12 patients was transpedicular screws system fixation,18 patients was lateral mass screws system fixation,1 patient was interspinal wires fixation.The fusion of the injured segments were observed on the X-ray film.The function of the spinal cord was evaluated with Frankle classification.Results 1 patient was died because of respiratory failure caused by spinal cord injury,2 patients lost follow up,28 patients were followed up from12 to 18 months(mean 14 months).Except the spinal cord function of the 4 frankel A cases gained no recovery,the spinal cord function of the others improved at different extents.The function of the spinal cord improved 1.1 grade after operation according to the frankle classification.All grafts got fused in 4~6 months.Conclusion This method can be reliable,adequate decompression and also can increase the stability of cervical spine,facilitate postoperative care and exercise,reducing complications,early rehabilitation of spinal cord function to provide effective protection.更多还原