摘要
目的探讨采用一期后-前路联合手术治疗陈旧性下颈椎牵张-屈曲型损伤的经验和远期效果。方法回顾性分析采用一期后路棘突间钢丝固定、前路减压、植骨融合、钉板系统内固定术式治疗陈旧性下颈椎牵张-屈曲型损伤病例22例（第3~4颈椎、第5~6颈椎20例,第6~7颈椎2例）,随访时间0.5~9.5年。分析手术前、后症状、神经功能变化及影像学资料,总结术式经验及远期效果。结果 22例患者中,20例颈部疼痛明显缓解并达到骨性融合（91%）,2例尚在随访中。手术后神经根功能恢复良好,2例残留有神经根症状（9%）。2例第6~7颈椎手术患者复位部分丢失,1例接受翻修手术（后路固定改为侧块钉-棒）,另1例患者因无症状拒绝翻修手术。结论一期后-前路联合手术治疗陈旧性下颈椎牵张-屈曲型损伤方法可行、有效,具有良好的远期效果。对于第6~7颈椎的陈旧性牵张-屈曲型损伤采用后-前-后路手术方式可能更为合理。
Objective To discuss the experiences and long-term effects of posterior-anterior combined procedures for treating old distractive flexion injuries（DFI,stage 2 and 3） of subaxial cervical spine.Methods Totally 22 cases（20 cases of C3-4 and C5-6,2 cases of C6-7） of old DFI treated by posterior interspinous wire fixation and anterior plate fixation were retrospectively analyzed.The follow-up ranged from 0.5 year to 9.5 years.The symptoms,neurologic function and radiography before and after treatment were analyzed and the experiences and long-term effects of the approach were summarized and assessed.Results Pain in the neck was remarkably alleviated and bony fusion was achieved in 20 cases（91%）.Neurological function recovered well in all cases after the treatment,with residual radiculopathy being observed only in two cases（9%）.Two cases（C6-7）exhibited partial lass of reduction after the operation,one was subjected to the revision surgery of posterior release,anterior plate fixation and posterior lateral mass fixation while the other refused with no significant symptom being observed.Two cases were still in the follow-up.Conclusion Treating old DFI with posterior-anterior combined procedures is feasible and effective and has long term therapeutic effects,while traditional approach via anterior-posterior-anterior maybe more reasonable for old DFI at C6-7.
出处
《局解手术学杂志》
2010年第5期374-376,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
前路融合
后路融合
颈椎创伤
anterior cervical fusion
posterior cervical fusion
cervical spinal trauma
