无脊髓损伤颈椎骨折脱位的治疗分析

目的 探讨无脊髓损伤颈椎骨折脱位的治疗方法选择。方法 28例无脊髓损伤的颈椎骨折或骨折脱位，新鲜损伤26例，陈旧性损伤2例；其中23例手术治疗；5例保守治疗。结果 全部病例随访观察，症状均获得改善，17例完全恢复，7例残留手指麻木，4例颈椎旋转受限，颈椎椎间高度、生理曲度维持良好。结论 对于无脊髓损伤的稳定性上颈椎骨折脱位行牵引、制动、复位和固定，而不稳定性上颈椎骨折脱位应手术治疗；对于无脊髓损伤的下颈椎骨折脱位宜首选经前路手术治疗，前路手术除可达到减压、恢复颈椎椎间高度和生理曲度外，更重要的是可重建颈椎即刻稳定性，对防止继发性脊髓损伤有极其重要的作用。

Clinical study on fractures and dislocations of cervical spine without spinal cord injury

Objective To discuss and compare the treatments for cervical spinal fractures and dislocations without spinal cord injury.Methods 28 cases of cervical spinal fracture or fracture-dislocation without spinal cord injury,including 26 fresh ones and 2 old ones,were treated.23 cases underwent surgical treatment,while 5 cases underwent conservative treatment.Results The follow-ups showed that clinical manifestations had improved in all eases and 17 cases had got completely recovered,but liial finger-numbness had occurred in 7 cases and relational restriction in 4 cases but with good inlervertebral height and physiologic curve.Conclusions Conservative treatment is re commendable for stable superior cervical spinal fractures and dislocations without spinal cord injury,while surgery more suitable for unstable cases.Anterior approach is preferred to lower cervical spinal fractures and dislocations without spinal cord injury,for it can render not only complete decompression,excellent maintenance of intervene bra I height and physiologic curve,but more importantly also immediate stabilization of cervical spine so as to prevent secondary injury to spinal cord.