Korkala O, Kytömaa J
Arch Orthop Trauma Surg (1978). 1984;103(5):353-5. doi: 10.1007/BF00432425.
The mode of treatment of late diagnosed lower cervical spine dislocations is a matter of controversy. Some workers consider surgical reduction 2 weeks after the trauma contraindicated, preferring posterior fusion in situ despite neurological defects. Classic techniques of posterior fixation by interspinous wiring may be insufficient in late reduced cases. This is especially true in the case of fracture of the posterior arch or the base of the spinous process, or if a laminectomy has been performed. Two complete dislocations of the lower cervical spine were reduced 2 and 8 weeks after the trauma in combination with posterior fixation using the Daab plate and posterolateral fusion. Both patients had marked neurological defects which were significantly alleviated after the operation; a solid fusion was achieved in both cases.
晚期诊断出的下颈椎脱位的治疗方式存在争议。一些研究者认为创伤后2周进行手术复位是禁忌的，即使存在神经功能缺损，也更倾向于原位后路融合术。对于晚期复位的病例，经典的棘突间钢丝后路固定技术可能并不充分。在后弓或棘突基部骨折的情况下，或者已经进行了椎板切除术时，尤其如此。两例下颈椎完全脱位患者分别在创伤后2周和8周进行了复位，并使用Daab钢板进行后路固定及后外侧融合。两名患者均有明显的神经功能缺损，术后显著缓解；两例均实现了牢固融合。
