急诊手术治疗新鲜下颈椎骨折脱位并脊髓损伤的疗效分析

目的：：分析急诊手术治疗新鲜下颈椎骨折并脊髓损伤的临床疗效。方法：30例新鲜下颈椎骨折脱位患者急诊行牵引复位、前路减压植骨钢板内固定术进行治疗，随访1年，观察颈椎复位、植骨融合和脊髓神经功能恢复情况。结果：患者术后6个月均获得良好骨性融合，植骨融合率为100%；术后椎体间移位距离明显短于术前，术前、术后比较差异具有统计学意义(P＜0.05）；30例患者，2例患者存留Ⅰ°脱位，复位率为93.33%（28/30）。术后1年患者的ASIA分级平均提高1.5级。结论：新鲜下颈椎骨折脱位宜急诊行牵引复位、前路减压植骨钢板内固定术进行治疗，可在最短时间内重建颈椎的稳定性，恢复颈椎高度和曲度，防止继发性脊髓损伤。

CURATIVE EFFECTS IN TREATMENT OF FRESH LOWER CERVICAL FRACTURE DISLOCATION AND SPINAL CORD INJUYRY WITH EMERGENCY OPERATION

ABSTRACT]Objective:To analyze the curative effects in treatment of fresh lower cervical fracture dislocation and spinal cord injury with emergency operation. Methods:30 cases fresh lower cervical fracture and dislocation patients were all treated with urgent traction reduction, anterior decompression, bone grafting and internal ifxation. The cervical vertebrae reduction, bone graft fusion and functional recovery of spinal cord of 30 patients were observed after 1 year follow-up. Results:All the patients obtained better bone graft fusion 6 months after operation and the bone graft fusion rate was 100%. The displacement between cervical vertebrae after operation was obviously shorter than that before operation (P<0.05). The reduction rate of 30 patients was 93.33%(28/30) because 2 patients leftⅠ° dislocation. The ASIA grade after operation increased on average 1.5 grade. Conclusions:Fresh lower cervical fracture and dislocation should be treated with urgent traction reduction, anterior decompression, bone grafting and internal ifxation, which can reconstruct cervical stability, restore the height and curvature of cervical vertebrae and prevent secondary spinal cord injury.