摘要
[目的]探讨后路全椎板减压联合椎弓根内固定治疗下颈椎骨折脱位的适应证、疗效和安全性。[方法]2005年6月～2008年2月,对41例颈椎骨折脱位的患者进行了后路全椎板减压复位,椎弓根系统内固定手术治疗。其中男32例,女9例;年龄22～47岁,平均33.5岁;38例为新鲜外伤,3例为陈旧骨折脱位。[结果]所有手术顺利完成,未发生严重的围手术期并发症。共置钉282枚,有252枚完全位于椎弓根内,准确率为89%。手术时间2.5～4h,平均3.1h;术中失血量250～950ml,平均460ml。随访时间24～36个月,平均27.5个月。所有患者复位满意,无内固定失败。32例获得2年以上随访的患者均获得骨性融合。术后2年ASIA92评分与术前有显著性差异(P<0.05)。[结论]若能准确的把握适应证,后路全椎板减压联合椎弓根螺钉内固定治疗下颈椎骨折脱位手术安全,效果满意。
[Objective]To evaluate the indications,efficacy and safety of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation.[Method]From June 2005 to February 2008,41 patients with lower cervical fracture and dislocation received posterior total laminectomy decompression and reduction with pedicle screws.The patients（M=32,F=9）were 22-47 years old,with an average of 33.5 years old.There were 38 fresh and 3 old injuries.[Result]All the patients were operated on successfully without severe complications during perioperative period.Totally 252 （89%） screws were exactly implanted in the cervical pedicle.The everage surgery time was 3.1 h （2.5-4 h）.The average blood loss during the operation was 460 ml （250-950 ml）. The average time of follow-up was 27.5 months（24-36 months）. All patients had satisfiactory reduction and no internal fixator failure.Thirty-two patients who were followed up for more than 24 months had complete fusion. The motor and sensory score （ASIA92） were improved significantly at 2 years follow-up（P0.05）.[Conclusion]Posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation is a safe and effective technique for freatment of lower cervical fracture and dislocation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第10期821-824,共4页
Orthopedic Journal of China
关键词
颈椎
骨折脱位
椎弓根螺钉
内固定
cervical spine
fracture and dislocation
pedicle screw
internal fixation
