椎动脉损伤后颈椎前路减压的疗效评价

目的 探讨闭合性椎动脉损伤对颈椎前路减压脊髓功能改善的影响.方法 本组439例闭合性颈椎创伤患者,颈椎骨折351例,双侧小关节脱位39例,单侧小关节突脱位37例,无放射影像异常脊髓损伤12例,全部患者接受前瞻性颈椎MRI及椎动脉MRA检查,对有手术指征患者施行了颈椎前路减压融合.结果 本组439例闭合性颈椎创伤患者,78例继发有椎动脉损伤,单侧77例,双侧1例.76例单侧椎动脉损伤患者施行了颈椎前路减压手术,术后全瘫患者中7例损伤平面有上升,33例不全瘫患者神经功能均有不同程度恢复,但改善幅度小于同期完成的不伴椎动脉损伤的患者.结论 椎动脉损伤有可能影响颈椎前路减压脊髓功能的改善.

Influence of close vertebral artery injury on clinical results of anterior cervical decompression

Objective To study the influence of close vertebral artery injury on the neurological function recovery of anterior cervical decompression. Methodes There were 439 patients with close cervical spine trauma. Of all the patients, 351 were cervical spinal fractures, 39 bilateral facet dislocations, 37 unilateral facet dislocations, and 12 spinal cord injuries without radiogrophic abnormality. All the patients underwent the prospective examination of cervical spine MRI and vertebral artery 2D TOF MRA. Anterior cervical decompression was performed for the patients having indication. Results Vertebral artery injury was detected in 78 of the 439 patients. There were 77 patients with unilateral vertebral artery injury and one patient with bilateral vertebral artery injury. In the 78 patients with vertebral artery injury, 76 patients were undergone anterior cervical decompression. The injury level of spinal cord raised in 7 patients with complete quadriplegia postoperatively. While neurological function was recovered different degree in 33 patients with incomplete spinal cord lesion postoperatively. But the range of recovery was less than the patients without vertebral artery injury. Conclusion Close vertebral artery injury may have an effect on the neurological function recovery of anterior cervical decompression.