Boccanera L, Laus M
I Divisione, Unità Operativa di Chirurgia Vertebrale, Centro Traumatologico Ortopedico, Bologna Ovest.
Ital J Orthop Traumatol. 1988 Sep;14(3):293-300.
Isolated traumatic cervical radicular lesions are rare. They constitute only 3% of the neurological lesions due to spinal trauma. A monolateral radicular lesion (Type A) is occasionally associated with medullary damage (Type B), resulting in a more complex neurological syndrome. Type A lesions are caused by flexion/rotation with fracture of the upper part of an articular facet and rotatory dislocation of the vertebra above, or by a pure monolateral dislocation. Reduction by halo traction followed by halo plaster gives good results even when the anatomical result is imperfect. Operative treatment of these lesions is required only in cases which cannot be reduced nonsurgically. Type B myelo-radicular lesions are caused by hyperextension-rotation injuries with displaced fractures of the facets and secondary subluxation. The treatment is surgical; reduction by a posterior approach with fixation by Roy-Camille plates, but must include radicular release by removal of the fractured joint mass.
孤立性创伤性颈神经根损伤较为罕见。它们仅占脊柱创伤所致神经损伤的3%。单侧神经根损伤（A型）偶尔会合并脊髓损伤（B型），从而导致更复杂的神经综合征。A型损伤是由关节突上部骨折伴上位椎体旋转脱位的屈曲/旋转损伤，或单纯单侧脱位引起。即使解剖复位效果不理想，通过头环牵引随后行头环石膏固定也能取得良好效果。这些损伤仅在非手术无法复位的情况下才需要手术治疗。B型脊髓神经根损伤是由伴有小关节移位骨折和继发性半脱位的过伸-旋转损伤引起。治疗方式为手术治疗；采用后路复位并用Roy-Camille钢板固定，但必须通过切除骨折的关节块进行神经根松解。
