颈椎前路内固定失败翻修一例报告

我科于2011年5月收治颈椎前路内固定术后钢板松动行翻修手术病例1例,现报道如下. 临床资料 患者,男,32岁,因"颈椎骨折并脊髓损伤术后8个月,发现内固定松动40余天"于2011年5月入院.患者2010年8月因头颈部外伤导致C5、C6椎体骨折并四肢瘫痪,在外院行C5、C6椎体切除钛笼植入前路钢板内固定手术.

A case report of the revision after a failed anterior cervical internal fixation

Objective To analyse the causes of the failure and the surgical approach of the revision after a failed anterior cervical internal fixation in 1 case. Methods Loose screws and steel plates were removed first. The decompression of the anterior cervical spinal cord was conducted. Afterwards a titanium mesh and a steel plate were again implanted for fixation. Finally, posterior screw-rod fixation system was employed to strengthen the fixation. Results The cervical spinal cord was decompressed. The height of cervical vertebrae and the physiological curve were restored in general. According to the American Spine Injury Association （ASIA） standard, the function of cervical spinal cord was recovered from A preoperatively to C postoperatiVely 2 months after the surgery. Conclusions Primary anterior-posterior operation is a comparatively good choice for the cervical fracture and dislocation with spinal cord injury. The revision surgery should decompress the cervical spinal cord completely and restore the height of cervical vertebra and the physiological curve.