下颈椎单侧关节突交锁脱位的治疗分析

目的提高下颈椎单侧关节突交锁脱位的疗效.方法1997年12月至2004年12月我院共收治的203例颈椎损伤患者,其中21例为下颈椎单侧关节突交锁脱位,C3-4位3例,C4-5位5例,C5-6位7例,C6-7位6例.15例经颅骨牵引复位后头颈胸石膏或支具固定;3例经颈椎后开放复位并行棘突钢丝缠绕固定;3例先行后路开放复位或术中麻醉下复位,再行前路椎间盘减压及钢板内固定治疗.结果21例患者就诊时按ASIA分级:A级2例,B级7例,C级8例,D级3例,另1例表现为轻微神经根刺激症状;三个月后ASIA分级:A级1例,B级2例,C级5例,D级8例,E级6例,1例伴全瘫出院后6个月并发肺炎死亡.结论早期明确诊断、早期快速牵引复位减压、早期开放复位减压稳定性重建对颈髓损伤预后有利.

Early Diagnosis and Treatment of unilateral Lower Cervical Spine Locked Facet

Objective To improve the clinical effect of unilateral cervical spine locked face. Methods 203 patients suffering from lower cervical injury from December 1997 to December 2004 were treated. 21 eases of them were unilateral Lower Cervical Spine Locked Facet. 3 patients were dislocated at C3-4. 5 patients were dislocated at C4-5. 7 patients were dislocated at C5-6. 6 patients were dislocated at C6-7. 15 patients were fixed with plaster splint or supporting instrument by craniums tractor. 3 patients were fixed with spinal steel wire by open cervical vertebra reduction. 3 patients were treated by open rearward reduction or anesthesia afterwards reduction, and fixed internal steel plate by forward, intervertebral disc decompress. Results The 21 patients, according to ASIA Classification Standard, were showed A in 2, Bin 7, C in 8, D in3. The other one showed slight nerve ending excite symptoms. After 3 months, They were showed A in 1, B in 2, C in 5, D in 8 and E in 6. One patient suffering from paralysis and died from pneumonia 6 months later. Conclusions The principle should be obeyed so that early, heavy-welght traction in combination with rapid tact reposition could reduce the pressure completely and reconstruct the stability of the spine when treated with double eervieul spine locked face. Anterior decompression is a rational surgery method.