Sonntag V K
Neurosurgery. 1981 Feb;8(2):150-2. doi: 10.1227/00006123-198102000-00002.
The management of 15 cases of bilateral locked facets of the cervical spine is reviewed. The C-6, C-7 interspace was the most common interspace involved. There were 4 females and 11 males who were 16 to 63 years old (average, 26 years). Thirteen patients had a complete spinal cord lesion with loss of function below the level of the locked facets. Two had intact dorsal column function. One patient had an ascending spinal cord deficit, which did not change after open reduction. The remainder had no change in spinal cord function after reduction. However, after reduction, 1 patient had a transient root deficit and 2 patients improved in the function of the involved roots. Closed reduction was accomplished by (a) skeletal traction and weight application, (b) manual reduction under sedatives, or (c) manual reduction under general anesthesia. Five patients required open reduction. The failure of closed reduction was attributed to accompanying fractures of one of the facets in 2 cases, increasing neurological deficits during traction in 2 cases, and associated higher cervical fractures in 1 case. Internal stabilization with wire and bone or external stabilization with a halo vest or a brace was used. Twelve patients were followed for 1 1/2 to 7 years (average, 2.7 years). Stabilization after reduction was successful irrespective of the methods used. The various methods of reduction and stabilization are reviewed and discussed.
回顾了15例双侧颈椎小关节交锁的治疗情况。C-6、C-7间隙是最常受累的间隙。患者共15例，其中女性4例，男性11例，年龄16至63岁（平均26岁）。13例患者存在完全性脊髓损伤，损伤平面以下功能丧失。2例患者的背柱功能完整。1例患者存在上升性脊髓功能障碍，切开复位后无变化。其余患者复位后脊髓功能无变化。然而，复位后，1例患者出现短暂性神经根功能障碍，2例患者受累神经根功能改善。闭合复位方法包括：(a) 颅骨牵引并施加重量；(b) 在镇静剂作用下手法复位；或(c) 在全身麻醉下手法复位。5例患者需要切开复位。闭合复位失败的原因包括：2例患者伴有一侧小关节骨折，2例患者牵引过程中神经功能缺损加重，1例患者伴有高位颈椎骨折。采用钢丝和骨进行内固定或使用头环背心或支具进行外固定。12例患者随访1.5至7年（平均2.7年）。无论采用何种方法，复位后固定均获成功。本文对各种复位和固定方法进行了回顾和讨论。
