下颈椎粉碎性骨折伴脊髓损伤的手术治疗

目的：探讨前路椎体次全切除和钢板系统固定在治疗下颈椎粉碎性骨折中的应用；方法：对16例下颈椎粉碎性骨折伴脊髓损伤的病人，先行颈椎牵引、药物治疗，于伤后1周行颈前路椎体次全切除植骨融合和钢板内固定术；结果：随访6—42个月，16例植骨均骨性愈合，ALIA脊髓损伤的分级恢复1—3级，无术后加重和因手术所致并发症；结论：颈前路椎体次全切除植骨融合和钢板内固定具有如下优点：颈前路椎体次全切除具有减压充分、可探查脊髓前方压迫情况；钢板内固定可获得即刻稳定，便于护理和功能锻炼；取髂骨作植骨融合的融合率高和获得长期稳定；是治疗下颈椎粉碎性骨折安全有效的治疗方法。

Surgery of Burst Fracture of Lower Cervical Vertebrae with Spinal Cord Injury

Objective:To discuss anterior subtotal vertebrectomy and plate system fixation for treatment of burst fracture of lower cervical vertebrae.Method:Sixteen patients of comminuted fracture of lower cervical vertebrae with spinal cord injury were treated by neck traction,medication and operation with anterior subtotal vertebrectomy,fusion and plate system fixation after 1 week. Result:All cases were followed up from 6 to 42 months,all had bone union of the graft and improved 1 to 3 degree of the ASIA.No case had aggravation and complication after operation.Conclusion:The method of anterior subtotal vertebrectomy,fusion and plate system fixation has excellent result:for example,this method has sufficient decompression of the pressure at frontage of spinal cord,plate system fixation has shortly stabilization,easy to nurse and take exercise,implant with ilium has high bone union rate and long stabilization.It is a safe efficient method for comminuted fracture of lower cervical vertebrae.