颈椎侧块及椎弓根钉棒治疗颈椎骨折脱位

目的探讨颈椎侧块及椎弓根钉棒固定、减压治疗颈椎骨折脱位伴多节段颈髓损伤的疗效。方法 2007年1月至2010年12月我科采用改良A nderson方法固定颈椎侧块,结合C2、C7椎弓根螺钉的联合应用,治疗颈椎骨折脱位伴多节段脊髓损伤34例,其中男26例,女8例;年龄18~64岁,平均41岁。按F ranke l分级标准评价,A级5例,B级20例,C级9例,入院时JOA评分平均6.8分,评价术后效果。结果术后随访6~24个月,平均15个月。术后颈椎完全复位33例,复位不完全1例。依据术前、术后JOA评分结果,术后改善率平均为62%;术后F ranke l分级平均提高1级以上。结论颈椎侧块联合椎弓根钉棒内固定可使受损颈椎获得即刻稳定,有利于脊髓功能恢复。

The Use of Cervical Lateral Mass and Pedicle Screw for the Treatment of Fracture and Dislocation of the Cervical Spine with Multiple Cervical Spinal Cord Injury

Objective To assess the effect of cervical lateral mass and pedicle screw fixation to treat fractures and dislocation of the cervical spine with multiple cervical spinal cord injury.Methods Using Improve Anderson method fixing lateral mass and pedicle screw in C2,C7,to treat cervical fracture-dislocation with spinal cord injury in multiple segments,and evaluating results.Results All patients were followed up from 6 to 24 months,with an average of 12 months.All cases,except one,got completely reduction after operation.According to Japanese Orthopaedic Association(JOA) grading,the improvement rate was 62%.Patients with incomplete SCI had significant improvement of one Frankel level.Conclusion The method of screw-rod fixation in lateral mass combined with pedicle screw can restore stability immediately,which is helpful to the spinal cord function recovery.