Khezri Navid, Ailon Tamir, Kwon Brian K
Division of Neurosurgery, University of British Columbia, 3100, 950 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.
Vancouver Spine Surgery Institute, Division of Neurosurgery, Department of Surgery, University of British Columbia, 818 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.
Neurosurg Clin N Am. 2017 Jan;28(1):125-137. doi: 10.1016/j.nec.2016.07.005. Epub 2016 Nov 3.
Facet injuries are common in the cervical spine. Many classification systems over the years have characterized the heterogeneity of these injuries. For unilateral facet fractures with minimal displacement and no neurological deficit, there is mounting evidence that better radiographic and clinical outcomes may be achieved with surgical treatment. Anterior and posterior approaches can both be utilized successfully for the surgical management of facet injuries. The anterior approach is well tolerated, allows one to address a disc herniation, and provides a high union rate with good sagittal alignment. The posterior approach allows for easier open reduction and biomechanically superior fixation.
小关节损伤在颈椎中很常见。多年来,许多分类系统都对这些损伤的异质性进行了描述。对于移位极小且无神经功能缺损的单侧小关节骨折,越来越多的证据表明,手术治疗可能会取得更好的影像学和临床效果。前路和后路手术均可成功用于小关节损伤的外科治疗。前路手术耐受性良好,能够处理椎间盘突出问题,并且融合率高,矢状位对线良好。后路手术便于进行更简便的切开复位,且生物力学固定效果更佳。