Kamal Younis, Ortho M S, Khan Hayat Ahmad, Gani Naseemul, Haq Ansar Ul, Gul Snobar, Singh Dara
Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email
DNB ortho, Senior Resident, Postgraduate Department of Orthopaedics, GMC SRINAGAR, Email
Int J Health Sci (Qassim). 2014 Oct;8(4):335-45.
The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest.
Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E).
The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodeficit was observed during the follow up period.
The clinical as well as radiological outcome of these injuries is mostly satisfactory with the conservative management using Halovest. More studies should be conducted to form the guidelines regarding patient selection for conservative management using halovest.
关于寰椎和枢椎损伤的不同模式及其适当治疗方法以及这些损伤治疗方面的逐步发展,在全球范围内的文献都很匮乏,因此我们在此介绍应用头环背心治疗这些损伤的经验。
对30例(22例男性,8例女性)寰椎和枢椎损伤患者进行治疗,随后平均随访24个月。分析了损伤类型以及头环背心在这些损伤治疗中的使用情况的数据。对有神经功能缺损的患者按照美国脊髓损伤协会(ASIA)分级量表(从A级到E级)进行评分。
头环背心固定用于寰椎和枢椎损伤的平均时间为12±3周(范围9至15周)。4例患者有神经功能缺损。2例患者从ASIA C级恢复到ASIA D级。1例患者从ASIA D级改善到ASIA E级,而1例有神经功能缺损的患者失访。随访期间未观察到死亡或神经功能缺损恶化情况。
使用头环背心进行保守治疗,这些损伤的临床及影像学结果大多令人满意。应开展更多研究以形成关于使用头环背心进行保守治疗的患者选择的指南。