下位颈椎骨折脱位合并关节突绞锁骨折的早期手术治疗

目的 探讨一种早期经后路切开复位完成下位颈椎稳定手术的方法，以解决合并关节突绞锁、骨折的颈椎骨折、脱位复位的问题。方法 14例合并关节突绞锁、骨折的颈椎骨折、脱位病人，其中6例前后路手术一次完成，后路手术切开复位，前路椎闻植骨，钛合金自锁钢板(CSIJ)内固定；其余8例先行后路切开复位、棘突间钢丝内固定，择期行前路椎间植骨融合术。结果 14例脱位颈椎全部达到解剖复位，使脊髓受压迫状态解除，神经功能按Frankel分级均提高l～2级。结论 合并关节突绞锁、骨折的颈椎骨折、脱位早期切开复位是可行的，对解除脊髓的压迫状态，挽救脊髓残留的神经功能，促进恢复有利。

Early operative treatment of the fracture-dislocation of infra-cervical vertebra combine with articular process interlocking or fracture

Objective: To explore an operative treatment for the fracture or dislocation of cervical spine complicated with articular process interlocking or fracture Methods: 14 cases of fracture or dislocation of cervical spine complicated with articular process interlocking or fracture were treated,6 cases of them underwent the posterior approach open reduction and the anterior approach operation of bone implanting and internal fixation by CSLP at the same time.For the other 8 cases whose health condition were not well enough,we performed open reduction posteriorly and internal fixation by steel wire between spinous process at first,and intervertebrae fusion anteriorly with implanted bone was done later.Results: All 14 cases of the fracture or dislocation of cervical spine were reduced perfectly and spinal cord compression were relieved.The neural function recovered 1 to 2 levels according to the Frankel classification.Conclusion: The Results showed that early open reduction for cervical fracture or dislocation complicated with articular process interlocking or dislocation is possible,which can relieve compression and remedy neural function of spinal cord.