颈椎钩突骨折的损伤机制与治疗

目的　探讨颈椎钩突骨折的损伤机制及诊治特点。　方法　回顾分析自 1976年 1月至 1999年 12月收治的 9例颈椎钩突骨折 ,其中男 4例 ,女 5例 ;年龄 18～ 31岁 ,平均 2 3.5岁。单侧颈椎钩突骨折 5例 ,双侧颈椎钩突骨折 2例 ,同侧 2个颈椎钩突骨折 2例。C5钩突骨折 4例次 ,C6 钩突骨折 7例次。非手术治疗 3例 ,手术治疗 6例。全组获随访 3～ 2 4年 ,平均 11年。结果　本组手术治疗患者效果优良 ;非手术治疗患者遗留不同程度颈痛、头晕、手麻等症状 ,其中 2例患者 30岁时有明显颈椎退变 ,3例患者 35岁时均诊断为颈椎病。　结论　本组颈椎钩突骨折的损伤机制是由于颈部的瞬时旋转和侧屈暴力造成 ,且有颈部侧屈和 (或 )旋转位受伤史。一旦颈椎左右侧屈正位片X线检查发现一侧椎间隙增宽 (>2mm) ,应行CT检查明确诊断 ,CT扫描层厚最好控制在 2mm。该种骨折如果治疗不当 ,将明显提前颈椎病发生时间

The injury mechanism and treatment of uncinate process fracture of cervical spine

Objective To explore the injury mechanism and treatment of uncinate process fracture of the cervical spine. Methods Nine cases (4 males and 5 femals) at ages of 18-31 years (mean 23.5 years) who were admitted into our department from January 1976 to December 1999 were reviewed. There were 5 uni lateral fractures, 2 bilateral fractures and 2 fractures involving uncinate processes of 2 cervical vertebrae. There were 4 cases of C 5 fractures and 7 cases C 6 fractures. Six cases were given operation but three cases non-operation. All the cases were followed up for 3-24 years (average 11 years). Results Operation won good results. However, in the non-operation group, different degrees of neck pain, dizzy and hand numbness were left. Two cases showed obvious degeneration of cervical spine when they were at age of 30 years. Three cases were found with cervical spondylosis when they were 35 years old. Conclusions The fractures were resulted from instantaneous rotation and lateral flexion of the neck. Once an X ray examination shows that an intervertebral space is wide more than 2 mm under an anteroposterior view of right and left flexion of the cervical vertebra, CT scan (the best thickness is 2 mm) should be applied for a specific diagnosis. If such kind of fractures are treated improperly, the cervical spondylosis will occur more earlier than expected.