Louis R
Nouv Presse Med. 1979 May 19;8(22):1843-9.
The cervical spine, containing twenty-articulations, is particularly exposed to sprains. Benign cases are those in which both spinal stability is not affected and only subjective neurovascular complaints are present. Management essentially involves constant volontary immobilization of the cervical spine with or without apparatus (Postural training). The severity of the sprains results from the possibility of either vertebral instability or objective neurovascular complications. Bony instability can be detected on dynamic radiographs based on precise criteria defined by physiologic study of normal spinal movements. When a persistant vascular syndrome involving the vertebro-basilar arteries is observed, vertebral arteriography may be indicated. Likewise, the presence of a thoracic outlet syndrome may required sub-clavian arteriography. Metrizamide myelography is used to explore neurologic lesions. The author concluded that only severe cervical sprains required surgical intervention. A prolapsed cervical disc, revealed by discography and especially metrizamide myelography, most often requires an anterior approach to surgery.
颈椎包含二十个关节，特别容易受到扭伤。良性病例是指脊柱稳定性未受影响且仅存在主观神经血管症状的情况。治疗主要包括使用或不使用器械持续主动固定颈椎（姿势训练）。扭伤的严重程度取决于椎体不稳定或客观神经血管并发症的可能性。根据正常脊柱运动的生理研究定义的精确标准，可在动态X线片上检测到骨不稳定。当观察到涉及椎基底动脉的持续性血管综合征时，可能需要进行椎动脉造影。同样，存在胸廓出口综合征可能需要进行锁骨下动脉造影。甲泛葡胺脊髓造影用于探查神经病变。作者得出结论，只有严重的颈椎扭伤才需要手术干预。经椎间盘造影尤其是甲泛葡胺脊髓造影显示的颈椎间盘突出，通常最需要采用前路手术。
