颈胸段脊柱骨折的临床特点及后路手术疗效探讨

目的探讨颈胸段脊柱脊髓损伤的临床特点及后路椎板减压、植骨、椎弓根螺钉内固定术的治疗作用。方法 8例颈胸段脊柱损伤患者,损伤部位为第6颈椎至第1胸椎,损伤类型为椎体爆裂性骨折2例,椎体压缩性骨折5例,压缩性骨折伴脱位1例。分析上述患者的临床表现,并分别经后路颈胸段椎板减压椎弓根或侧块螺钉内固定术。结果所有患者随访6~20个月,植骨均在3~4个月完全融合,所有患者术后脊髓神经功能均有不同程度症状改善,伴有交感神经节刺激症状者有所缓解。结论颈胸段后路椎板开窗减压植骨融合内固定术对颈胸段脊柱脊髓损伤具有较好的疗效。后路椎弓根螺钉及侧块螺钉固定系统有助于植骨节段融合、重建和稳定颈胸段脊柱。

Clinical characteristics of cervicothoracic spine fracture and efficacy of posterior operation

Objective To investigate the clinical characteristics of cervicothoracic spine fracture and spinal cord injury,as well as the therapeutic effects of posterior decompression,bone graft and transpedicular screw internal fixation.Methods The clinical characteristics of cervicothoracic spine fracture at C6～T1 in eight cases were analyzed,including two cases of vertebral burst fractures,five cases of vertebral compressoin fractures and one case of vertebral compressoin fractures with dislocation.Posterior decompression,bone graft and transpedicular screw internal fixation were performed in the cervicothoracic spine after analyzing the details of fractures.Results All cases were followed-up for 6～20 months.Complete fusion of grafted bone occurred within 3～4 months in all cases with no complications of loosening and breaking of plates and screws being observed.All cases experienced different degrees of improvements in spinal cord neurological function and those who had irritant symptoms in the sympathetic ganglia got relieved.Conclusions Posterior decompression,bone graft and transpedicular screw internal fixation are effective in the treatment of cervicothoracic spine fracture and spinal cord injury.Transpedicular screw internal fixation through posterior approach is helpful to fuse the grafted bone,reconstruct the cervicothoracic spinal column and maintain its stability.