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[颈椎骨折与脊髓损伤手术治疗中的前路入路]

[Anterior approach in the surgical treatment of cervical fracture and spinal cord injury].

作者信息

Zhang Hong-qi, Li Kang-hua, Long Wen-rong

机构信息

Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Hunan Yi Ke Da Xue Xue Bao. 2002 Apr 28;27(2):139-42.

Abstract

OBJECTIVE

To explore value of the anterior approach in the surgical treatment of cervical fracture and spinal cord injury.

METHODS

Thirty-one cases of cervical fracture and spinal cord injury were treated. All the patients were operated on in general anaesthesia by anterior decompression, reduction, auto-iliac graft and ORION cervical plate fixation. All the cases were evaluated according to Frankel criteria of the neural function preoperatively, and 3 months and 6 months after the operation.

RESULTS

Twenty-eight cases were followed up for an average of 13.8 months (ranging from 3 to 18 months). All the fractures and dislocations were reduced satisfyingly. All the bone-grafts were fused within 3 months after the operation. There was no plate or screw complication in any of the cases. The Frankel grade improvement rates were 50%, and 82.1% in 28 cases at 3 months and 6 months postoperatively; the average Frankel grade was improved by a 0.64 and 1.14 grade respectively.

CONCLUSION

For cervical fracture and spinal cord injury, an ideal reduction and immediate stability can be obtained through the anterior approach. Early surgery can significantly improve the spinal cord function and avoid missing the operation opportunity due to occurring complications.

摘要

目的

探讨前路手术在颈椎骨折并脊髓损伤治疗中的价值。

方法

对31例颈椎骨折并脊髓损伤患者进行治疗。所有患者均在全身麻醉下接受前路减压、复位、自体髂骨植骨及ORION颈椎前路钢板内固定术。所有病例术前、术后3个月及6个月均依据Frankel神经功能标准进行评估。

结果

28例获得随访,平均随访13.8个月(3至18个月)。所有骨折及脱位均获得满意复位。所有植骨均在术后3个月内融合。所有病例均未出现钢板或螺钉相关并发症。术后3个月及6个月时,28例患者的Frankel分级改善率分别为50%和82.1%;Frankel分级平均分别提高0.64级和1.14级。

结论

对于颈椎骨折并脊髓损伤,前路手术可实现理想复位并即刻获得稳定。早期手术可显著改善脊髓功能,避免因并发症发生而错过手术时机。

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