单纯颈椎屈曲骨折的手术治疗及内固定的选择(附32例病例分析)

目的:探讨下颈椎不稳定屈曲骨折并颈髓损伤后的手术治疗及内固定选择的适应症.方法:本组32例颈椎屈曲骨折均进行了手术治疗,分别选用颈椎前路ORION钢板及颈后路AXIS钢板或前后路钢板一期完成内固定治疗,且均获得不同程度改善,并进行了Frankel分级评定.结果:由于恰当地选择不同的手术方式及不同的内固定,使得颈椎得以早期获得坚强的内固定,部分患者得以早期下床,患者均获得早期功能锻炼.结论:颈椎屈曲骨折按照其手术治疗原则,恰当地选用不同术式及给以坚强的内固定利于颈椎骨折患者的早期康复,可以最低限度地减少颈髓神经的继发性损伤.而不适当的手术方式及不恰当的内固定同样能造成多样的颈椎畸形及颈髓神经的继发性损害.

The choice of surgical treatment and internal fixation of cervical vertebra instability bending fracture

Objective: To explore the choice of operative treatment and internal fixation in cervical vertebra instability bending fracture accompanied by cervical spinal cord injuries. Methods: The surgical treatment were selected in all 32 patients of cervical vertebra instability bending frature,anterior approachs ORION plates or posterior approachs AXIS being applied respective, or both applied instantaneous. The patients gained improvement of one Frankel Grade. Results: Due to correct choice of surgical approaches and internal fication,the cervical vertebra gained the stong fixation.Some patients could go to the fields, and have function exercise early. Conclusion: According to operative treatment principle of cervical vertebra instability bending fracture, correct surgical approaches and strong fixation advanced the early healing of patients, and decompress lated injuries of cervical spine cord nerve,and correct approaches and fixation might result in cervical vertebra abnormality and lated injuries of nerve.