Department of Spine Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
Med Sci Monit. 2017 Nov 29;23:5675-5682. doi: 10.12659/msm.907470.
BACKGROUND The aim of this study was to analyze the clinical features and to evaluate the efficacy of anterior partial corpectomy and titanium mesh fusion and internal fixation of old fracture dislocation of the lower cervical spine. MATERIAL AND METHODS We retrospectively analyzed the clinical data of 52 patients with old lower cervical fracture and dislocation treated with anterior partial corpectomy and titanium mesh fusion fixation between January 2008 and December 2013, with a mean follow-up period of 4.1 years. There were 35 males and 17 females. Patient radiological data and clinical parameters were recorded and compared before and after the operations. RESULTS The average follow-up was 4.1 years. Intervertebral height and physiological curvature were well-reconstructed for all cases. No loosening or rupturing of titanium plate or screw occurred. The neurological function of the patients with incomplete spinal cord injury was significantly improved, and the function of the nerve roots at the injury level was also improved in patients with complete spinal cord injury. Bone fusion was completed within 6 months to 1 year after surgery. CONCLUSIONS Completed decompression, sequence and physiological curvature of the cervical vertebra, immediate and long-term anterior cervical column support, and nerve function restoration can be achieved by using anterior partial corpectomy and titanium mesh fusion and internal fixation to treat old fracture dislocation of the lower cervical spine. For cases with locked facet joints or posterior structures invading the vertebral canal, the combined anterior and posterior approaches should be performed, when necessary, to achieve better results.
本研究旨在分析陈旧性下颈椎骨折脱位的临床特点,并评估前路部分切除钛网融合内固定术的疗效。
回顾性分析 2008 年 1 月至 2013 年 12 月采用前路部分切除钛网融合内固定治疗的 52 例陈旧性下颈椎骨折脱位患者的临床资料,平均随访时间为 4.1 年。其中男 35 例,女 17 例。记录并比较患者术前和术后的影像学资料和临床参数。
所有患者平均随访 4.1 年。所有病例的椎间高度和生理曲度均得到良好重建,钛板和螺钉无松动或断裂。不完全性脊髓损伤患者的神经功能明显改善,完全性脊髓损伤患者的损伤水平神经根功能也得到改善。术后 6 个月至 1 年内完成骨融合。
前路部分切除钛网融合内固定术治疗陈旧性下颈椎骨折脱位可达到完全减压、颈椎序列和生理曲度恢复、即刻和长期颈椎前柱支撑、神经功能恢复的效果。对于伴有交锁关节或后方结构侵犯椎管的病例,必要时可采用前后联合入路以获得更好的效果。