颈前路钛网联合ZEPHIR钢板内固定治疗外伤性颈椎失稳

目的：探讨颈前路钛网联合ZEPHIR钢板内固定术治疗外伤性颈椎失稳的手术方法和临床疗效。方法：采用颈椎前路手术治疗外伤性颈椎失稳32例，手术方式为充分椎管减压、受伤椎体次全切除、切除的椎体碎骨加钛网植骨融合、自锁ZEPHIR钢板内固定。术后对神经功能恢复、植骨愈合进行观察。结果：32例患者术后随访6～28个月，平均13个月。钛网植骨术后均在3～5个月内获得临床骨性融合，无钛网下沉、钢板螺钉松动等并发症。术后所有患者神经功能评价Frankel分级均有1～2个级别恢复。结论：对外伤性颈椎失稳患者早期手术，术中充分椎管减压，同时钛网加切除的椎体碎骨植骨并应用自锁ZEPHIR钢板内固定，可以得到较好的临床疗效，能够避免髂骨取骨的并发症，获得较好的神经功能恢复和钛网骨融合。

Treatment of Traumatic Instable Cervical Spine by Anterior Approach with Titanium Mesh and Internal Fixation with ZEPHIR Plate

Objective：To evaluate the methods and curative effects of early operation via anterior approach combined with titanium mesh and internal fixation with ZEPHIR plate for treating traumatic instable cervical spine. Methods：Thirty two patients with traumatic instable cervical spine were treated by sufficient de- compression in vertebral canal, partial resection of the involved cervical vertebrae, transplantation of titanium mesh and bone chips from broken vertebrae, internal fixation with ZEPHIR plate. During the postoperative followed-up period, the functional recovery of nerves and fusion of bone grafts were observed and evaluated. Resuits：Thirty two patients had been followed up for 6 -28 months, average of 13 months. Clinical bone fusion was obtained in all cases in postoperative 3 - 5 months, without any complications such as subsidence of titanium mesh, loosening of plate or screw were observed. According to Frankel classification, all cases improved nervous function for 1 to 2 grades. Conclusions：Patients with traumatic instable cervical spine can obtain better bone fusion and functional recovery of nerves by undergoing early surgical intervention, which including anterior cervical decompression, transplantation of titanium mesh together with bone chips, internal fixation with ZEPHIR plate. Furthermore, any complications caused by iliac bone graft could be avoided.