头环牵引外固定架治疗颈椎外伤的临床研究

目的]探讨头环牵引外固定架治疗颈椎外伤的临床疗效。方法]从1997年2月~2005年7月共收治129例颈椎外伤性骨折脱位患者。将129例病例随机分成2组,1组70例行头环牵引,其中31例头环牵引加背心带支架保守治疗,39例头环牵引加手术治疗(前路手术18例,后路手术17例,前后路联合手术4例);另1组59例行颅骨牵引,其中13例颅骨牵引加支具保守治疗,46例颅骨牵引加手术治疗(前路手术22例,后路手术20例,前后路联合手术4例)。结果]随访6~48个月,平均12个月。头环牵引与颅骨牵引对上颈椎骨折脱位的复位作用无明显差异;对下颈椎骨折脱位的复位作用,统计学处理显示头环牵引组要明显好于颅骨牵引组,复位所需时间比颅骨牵引组短,完全复位率高,减压充分,更有利于脊髓功能恢复,治疗后离床时间头环牵引组要短于颅骨牵引组,2组患者治疗前后脊髓功能Frankel分级均有改善。结论]头环牵引外固定架可改善复位功能,对颈椎的牵引固定作用较颅骨牵引更为坚强稳定,使用安全方便。

Clinical reseach on the treatment of traumatic cervical fracture or dislocation with Halo-vest external immobilization

Objective] To evaluate the efficiency of Halovest external immobilization on the treatment of traumatic cervical fracture or dislocation.Method]From February 1997 to July 2005,129 patients with cervical fracture or dislocation were treated in our hospital;all the patients were divided into two groups randomly.First group: 70 patients were treated with Halo-vest traction,among them 31 patients were treated with Halo vest combined jacket orthosis;others were treated with Halo vests and surgery(anterior route approach 18 cases,posterior route approach 17 cases,4 patients operated by anterior and posterior approach).The second group: 59 patients were treated with skull traction.Among them 13 patients were treated with skull traction and orthosis,others were treated with skull traction and surgery(anterior route approach 22 cases,posterior route approach 20 cases,4 patients operated by anterior and posterior approach).Result]All the patients were followed 6~48 months(average 12 months).There was no statistical significance in two groups with reduction of upper cervical spine fracture and dislocation.However on the reduction of lower cervical injury groups,the prognosis with Halo-vest is significantly better than the other group.And the time for bed rest was much less than the skull traction.All the patients' spinal cord function improved obviously after treatment.Conclusion]Halo-vest external fixation is an easy and effective way to treat cervical injuries.It can improve the reduction of the cervical injuries and it's capability of reduction and maintenance are much better than skull traction.