下颈椎脱位早期前路手术复位疗效分析

目的观察下颈椎小关节脱位早期治疗选择前路手术复位、植骨融合内固定术的临床效果。方法早期前路切开颅骨牵引下旋转撬拨复位,一期椎间植骨融合内固定41例。结果一期复位成功36例,失败5例,成功率87.8%。33例获6～24个月随访,植骨均融合,无内固定松动及滑脱。神经损伤均有不同程度恢复。结论早期前路手术复位植骨融合内固定术优于手法复位及颅骨牵引复位,手术可早期进行,术后并发症少,康复良好,并可减轻护理难度。

Analysis of early anterior approach open operation and reduction of dislocation of lower cervical vertebrae

Objective To explore the operative treatment for the dislocation of lower cervical articular process with anterior approach of bone implanting and internal fixation. Methods 41 cases underwent early anterior approach open operation of bone implanting and internal fixation by skull traction, cervical vertebral rotation and reduction by leverage. Results 36 cases of dislocation of lower cervical articular process were reduced completely. The excellent rate of operation was 87. 8%. 5 failed. 33 cases were followed up for 6 -24 months. All bone graft got bony fusion. No implant loosening or displacement was found. Compromised nerve function got certain degree recovery. Conclusions Early anterior approach open treatment of bone implanting and internal fixation is a better method than manipulation and skull traction reduction. It can be performed in early period after injury, with few postoperative complications, good rehabilitation and relieving nursing care.