锁定板前路置入治疗颈胸段脊柱骨折脱位

背景：前路治疗颈胸段脊柱骨折脱位有关中长期临床效果及钢板置入后脊髓神经功能的报道很少。 目的：观察锁定板前路置入治疗颈胸段脊柱骨折脱位的可行性及疗效。 方法：回顾性分析2007-01/2011-01湘雅医院一附院脊柱外科收治的颈胸段脊柱骨折脱位患者12例,均采用前路减压、植骨、锁定板置入内固定治疗。 结果与结论：全部患者获随访一两年,均获得骨性融合,融合时间为4~8个月,无螺钉松动、脱落及锁定板断裂等并发症发生。锁定钢板置入前Frankel A级2例,置入后2例脊髓损伤无恢复;置入前B级4例,置入后恢复至C级2例,D级2例;置入前C级3例,置入后恢复至D级1例,E级2例;置入前D级3例,恢复至E级。1例置入后出现暂时性声音嘶哑,置入后3~6个月恢复。提示颈胸段前路减压、植骨、锁定钢板置入内固定对颈胸段脊柱脊髓损伤具有较好的疗效,锁定钢板有助于植骨节段融合、重建和稳定颈胸段脊柱。

Locking plate fixation for cervicothoracic fracture and dislocation through anterior approach

BACKGROUND:Few studies about the long-term clinical results of cervicothoracic fracture and dislocation treated via the anterior approach and the spinal cord function after locking plate fixation. OBJECTIVE:To find the feasibility and efficacy of locking plate fixation for cervicothoracic fracture and dislocation through the anterior approach.  METHODS:Twelve patients with cervicothoracic fracture and spine cord injury were retrospectively analyzed from January 2007 to January 2011. All cases were treated with anterior decompression and reduction, bone graft, and locking plate fixation. RESULTS AND CONCLUSION:All patients were followed up for 1 to 2 years, the mean follow-up time was 18 months. And all patients got complete bone fusion within 4 to 8 months postoperatively. There were no pull-out and breakage of screws or locking plate. Spinal cord functional recovery improved according Frankel standard. According to Frankel grades,there were 2 cases at grade A, 4 cases at grade B, 3 cases at grade C, 3 cases at grade D before implantation; 2 cases at grade A, 2 at grade C, 3 at grade D, 5 at grade E after implantation. One patients appeared with transient hoarse voice after surgery, and the symptoms were alleviated from 3 to 6 months after operation. Anterior decompression and reduction, bone graft, locking plate fixation have better effect for treatment of spine and spinal cord trauma in the cervicothoracic junction; the locking plate is helpful for the bone graft healing, reconstruction and stability in the cervicothoracic spine.