无脊髓损伤颈椎骨折脱位的外科治疗

目的：探讨无脊髓损伤的颈椎骨折脱位的手术治疗方法和技术改进。方法：对２２例无脊髓损伤的颈椎骨折或骨折脱位，其中新鲜损伤８例，陈旧性损伤１４例，采用经前路伤椎椎体次全切除减压，复位、自体髂骨植骨及ＡＯ纯钛带锁钢板固定的方法进行手术治疗。结果：术后全部病例经随访观察，症状获得改善，７例完全恢复。植骨在３个月内牢固融合，术后６个月，１６例重返工作，３例残留手指麻木。颈椎椎间高度、生理曲度维持良好，无钢板

Surgical management of fractures and dislocations of cervical spine without spinal cord injury

Objective: To study the surgical treatment for cervical spinal fractures and dislocations. Methods: Twenty two cases of cervical spinal fractures and dislocations without spinal cord injury, including 8 cases of fresh injury and 14 cases of old injury, were treated with anterior decompression, reduction, autograft and AO cervical spine locking plate fixation. Results: Clinical manifestations were improved in all cases and 7 cases got complete remission. Six months after surgery, 16 patients went back to work and 3 cases still felt finger numbness. Solid fusion was obtained within 3 months in all cases. Intervertebral heights and physiologic curves were kept well and there were no plate/screw break or loose. Conclusion: Anterior approach is preferred to cervical spinal fractures and dislocation without spinal cord injury. Through anterior approach, it is feasible to get complete decompression, good reduction and excellent maintenance of intervertebral heights and physiologic curves. More important, cervical spine can be stabilized immediately and secondary injury to spinal cord will be prevented.