【摘要】 目的应用3种不同手术方法治疗外伤性下颈椎骨折脱位,观察其疗效并进行对比,探讨其手术适应证。方法总结笔者自1997年1月～2006年1月收治的56例外伤性严重下颈椎骨折脱位的临床表现、不同手术方法、术式及其预后。结果术中均无大血管、气管、食管、脊髓意外发生,随访6个月～6年,平均18个月,未出现内固定钢板断裂、断钉、退出等并发症,植骨于术后12周均骨性愈合,无假关节、骨不连发生。术后颈椎高度、生理曲度无丢失。神经功能按Frankel分级均有1级以上的改善。结论对下颈椎骨折脱位应根据致压物的部位、小关节交锁情况、颈椎损伤程度、不稳定程度、受伤时间及自身的体质等选择手术方法。更多还原

【Abstract】 Objective To investigate how to select an appropriate surgical approach in treatment of the lower cervical spine fracture and dislocation.Methods A retrospective review of 56 patients with severe traumatic lower cervical spine fracture and dislocation between Jan.1997 and Jan.2006 was performed,including clinical manifestation,the surgical approaches and the prognosis.Results The mean follow-up period was 18 months(range:6 to 72 months).No great vessels,trachea,esophagus or spinal cord iatrogenic injury occurred.There were no pull-out and breakage of screws or plates.Fusion was achieved in all patients at an average of 12 weeks postoperatively.There were no pseudarthrosis or bone nonunion.The normal intervertebral height and lordosis were maintained.The nerve function was improved by 1 grade or more postoperatively according to the Frankel classification.Conclusion It is important to select a suitable surgical approach according to different types of cervical fracture and dislocation.更多还原