Toh Eiren, Nomura Takeshi, Watanabe Masahiko, Mochida Joji
Department of Orthopaedic Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.
Int Orthop. 2006 Feb;30(1):54-8. doi: 10.1007/s00264-005-0016-4. Epub 2005 Oct 25.
We reviewed the surgical treatment of 31 patients with burst fractures or teardrop dislocation fractures in the middle and lower cervical spine. Patients were treated with anterior instrumentation, posterior instrumentation, or a combination of both. Patients were evaluated radiographically and with the Frankel neurological outcomes grading scale. Anterior decompression and fusion restored the spinal canal diameter by approximately 60% whereas the posterior or combined approaches restored the canal diameter by only 6%. In addition, nine of 24 patients treated anteriorly gained improved neurological function whereas none of the patients treated posteriorly had neurological improvement. Based on the anatomical and neurological findings, the study demonstrates that anterior fusion is preferable to posterior fusion for the treatment of burst fractures and tear-drop dislocation fractures of the middle and lower cervical spine.
我们回顾了31例中下段颈椎爆裂骨折或泪滴状脱位骨折患者的手术治疗情况。患者接受了前路内固定、后路内固定或两者联合治疗。通过影像学检查和Frankel神经功能结果分级量表对患者进行评估。前路减压融合术使椎管直径恢复了约60%，而后路或联合手术仅使椎管直径恢复了6%。此外，24例接受前路治疗的患者中有9例神经功能得到改善，而后路治疗的患者中无一例神经功能改善。基于解剖学和神经学发现，该研究表明，对于中下段颈椎爆裂骨折和泪滴状脱位骨折的治疗，前路融合术优于后路融合术。
