Shao Xinwei, Zeng Jican, Chen Yuchun, Wu Lixian, Wang Xinjia
a Department of Spine Surgery, The Second Affiliated Hospital, Shantou University Medical College , Shantou, Guangdong 515041 , P. R. China.
b Department of Human Anatomy, Shantou University Medical College , Shantou, Guangdong 515063 , P. R. China.
J Invest Surg. 2019 Aug;32(5):446-453. doi: 10.1080/08941939.2018.1442533. Epub 2018 Mar 14.
: To analyze the mechanism of the halo vest-assisted Z-shape elevating-pulling reduction technique for cervical unilateral locked facets, and confirm the safety of the spinal cord under the epidural pressure that occurs during the reduction process. : Eleven osteoligamentous whole coronal and cervical spine specimens were established as skull-neck-thorax models of cervical unilateral locked facets at the C5/6 level. The halo vest-assisted Z-shape elevating-pulling reduction technique was then applied to reduce the locked facets. The changes in the epidural pressure in five cervical positions (cervical physiological curvature, cervical lateral bending, cervical unilateral locked facets, cervical unilateral perched facets, and reduction) were measured by a pressure sensor during the reduction procedure. The models simultaneously underwent multi-angle radiographic examination and CT scanning. : Successful closed reduction was achieved via the halo vest-assisted Z-shape elevating-pulling reduction technique in all 11 models. The epidural pressure in the cervical unilateral locked facets position was significantly higher than that in the other four cervical positions (P < 0.005). There was no significant difference in the epidural pressures measured during cervical lateral bending, cervical unilateral perched facets, and reduction. : Maximum epidural pressures were measured in the position of cervical unilateral locked facets. The halo vest-assisted Z-shape elevating-pulling reduction technique achieved spinal decompression without causing secondary spinal cord injury. The halo vest-assisted Z-shape elevating-pulling reduction technique is safe and effective, and has a high success rate of reduction.
分析头环背心辅助Z形提拉复位技术治疗颈椎单侧小关节交锁的机制，并证实复位过程中硬膜外压力下脊髓的安全性。：建立11个包含骨韧带的全冠状位颈椎标本，作为C5/6水平颈椎单侧小关节交锁的头-颈-胸模型。然后应用头环背心辅助Z形提拉复位技术复位交锁的小关节。在复位过程中，通过压力传感器测量五个颈椎位置（颈椎生理曲度、颈椎侧屈、颈椎单侧小关节交锁、颈椎单侧小关节脱位及复位）的硬膜外压力变化。模型同时进行多角度X线检查和CT扫描。：所有11个模型均通过头环背心辅助Z形提拉复位技术成功实现闭合复位。颈椎单侧小关节交锁位置的硬膜外压力显著高于其他四个颈椎位置（P<0.005）。颈椎侧屈、颈椎单侧小关节脱位及复位过程中测量的硬膜外压力无显著差异。：在颈椎单侧小关节交锁位置测量到最大硬膜外压力。头环背心辅助Z形提拉复位技术实现了脊髓减压，且未造成继发性脊髓损伤。头环背心辅助Z形提拉复位技术安全有效，复位成功率高。
