高位颈椎的前路手术治疗

目的观察高位颈椎前路手术的临床效果，方法本组15例．男10例，女5例．年龄12—67岁。C1，2椎体结核3例．Hangman 7例，先天性齿状突不连伴难复性环椎脱位3例，齿状突骨折2例。本组经高位前方咽后入路显露C2-3，椎体结核患者行病灶清除术．先天性齿状突不连者行前路松解复位．后路环枢融合；Hangman骨折。复位后行C2,3椎间植骨融合术．放自锁钛板内固定，齿状突骨折行前路中空螺钉内固定。结果15例患者均成功地显露C1前弓至C3椎体，并完成病灶清除、复位、减压融合内固定：无颈部重要血管神经损伤，无伤口感染．9例不全瘫有部分恢复。结论高位前方咽后入路可充分显露上颈椎．高位颈椎前路术式能有效复位、减压和稳定，并可最大程度重建颈椎生理功能。

Upper cervical spinal surgery from the high anterior cervical retropharyngeal approach

Objective To study the clinical result of the upper cervical spinal surgery from the high anterior cervical retropharyngeal approach. Methods There were 15 patients including 10 males and 5 females with the ages from 12 to 56 years. There were 3 C_ 1,2 tuberculosises, 7 Hangman fractures, and 3 irreducible atlantoaxial dislocations associated with os odontoideum and 2 dens fractures. All patients were treated with high anterior cervical retropharyngeal approach. Lesion clearance was performed for tuberculosises. C_ 2,3 fusion followed by self-locking plate was undergone for Hangman fractures. Ventral reduction following the posterior atlantoaxial fusion with brooks technique was taken for os odontoideum. Anterior screw fixation was used for dens fractures. Results Successful exposure, lesion clearance, reduction, decompression and fusion with internal fixation were achieved in all patients. There was no important vascular or nerve injury and no wound infection. Nine patients with incomplete quadriparesis recovered in different extent. Conclusion Good exposure of upper cervical spine could be gotten from the high anterior cervical retropharyngeal approach. Effective reduction, decompression and stability could be achieved in upper cervical spinal surgery from anterior approach. It could also reconstruct the cervical spine function in the maximum.