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治疗下颈椎单侧关节突关节绞锁的新复位技术:12例回顾性分析

New reduction technique for the treatment of unilateral locked facet joints of the lower cervical spine : A retrospective analysis of 12 cases.

作者信息

Wang Xinjia, Yao Guanfeng, Chen Yuchun, Wang Weidong, Zeng Jican

机构信息

Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China.

出版信息

Orthopade. 2018 Mar;47(3):212-220. doi: 10.1007/s00132-017-3456-9.

Abstract

BACKGROUND

Closed reduction of bilateral locked facet joints of the lower cervical spine is possible, but reduction of unilateral locked facet joints of the lower cervical spine (ULFJLCS) is challenging. We explored a new, simple, safe, and effective closed reduction method for the treatment of ULFJLCS.

METHODS

A retrospective analysis was done on 12 consecutive cases with traumatic ULFJLCS that underwent closed reduction by Z‑shape elevating-pulling reduction through a halo-vest. After reduction, only anterior cervical decompression and internal fixation were performed. The success of reduction and nerve function was assessed, and follow-up data analyzed.

RESULTS

All patients using our new reduction technique underwent successful closed reduction; the shortest time of reduction was 40 min and the longest 110 (mean, 65) min. No aggravation of neurological damage was observed, nor were other complications. All patients were followed-up from 28 to 72 (mean, 44) months after surgery. The improvement in Frankel's score (on average) was two levels in most patients.

CONCLUSION

These data demonstrate that our new reduction technique is a simple, safe, and effective treatment for ULFJLCS.

摘要

背景

下颈椎双侧小关节交锁可行闭合复位,但下颈椎单侧小关节交锁(ULFJLCS)的复位具有挑战性。我们探索了一种新的、简单、安全且有效的闭合复位方法来治疗ULFJLCS。

方法

对12例连续性创伤性ULFJLCS患者进行回顾性分析,这些患者通过头环背心经Z形提拉复位进行闭合复位。复位后仅行颈椎前路减压及内固定。评估复位成功率及神经功能,并分析随访数据。

结果

所有采用我们新复位技术的患者均成功进行了闭合复位;最短复位时间为40分钟,最长为110(平均65)分钟。未观察到神经损伤加重,也未出现其他并发症。所有患者术后随访28至72(平均44)个月。大多数患者Frankel评分平均提高两个等级。

结论

这些数据表明,我们的新复位技术是一种治疗ULFJLCS的简单、安全且有效的方法。

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