前后路一期手术治疗急性下颈椎严重损伤

目的 探讨前后路一期手术治疗急性严重颈椎损伤的价值。方法 分析总结采取前后路一期手术治疗8例急性严重颈椎损伤病人的临床资料及治疗效果。结果 所有病例均在受伤后96h内实施手术治疗，其中2例为爆裂骨折伴椎管狭窄，6例为骨折脱位伴有相应节段的椎间盘突出。术前脊髓功能7例为A级，1例为B级。平均随访14个月。脊髓功能有2例达到D级，3例C级，1例B级，2例无变化仍为A级。所有植骨椎间隙均已融合，椎间高度及生理曲度保持良好。结论 对于急性颈椎损伤，在影像学显示颈椎管前后方均有明显压迫且脊髓功能严重受损时，实施前后路一期手术是达到及时充分减压、即刻稳定、为脊髓功能恢复创造有利条件及减少并发症的有效手段。

Surgical treatment of severe lower cervical fracture by one stage anterior and posterior approach

Objective To evaluate the clinical results of one stage ante rior and posterior approach in the treatment of severe lower cervical injury. Me thod 8 cases of severe lower cervical injury underwent reduction, decompression and fixation through one stage anterior and posterior approach. 6 cases had fra cture and dislocation of cervical spine, and 2 cases cervical spine burst fractu re with cervical stenosis. Their clinical and radiographic records were reviewed retrospectively. Results Follow-ups of a mean period of 14 months showed that satisfactory recovery of neurological function was achieved. The Frankel Grade w as A in 7 cases and B in 1 case before operation, but D in 2 cases, C in 3 cases , and B in 1 case after operation except in 2 cases who had no improvement and r emained A. X-ray film demonstrated satisfactory stabilization of the fracture a nd dislocation, complete fusion of autograft, and preservation of the normal int ervertebral height and cervical lordosis. Conclusion One stage anterior and post erior approach operation is essential, safe and effective when radiographs demon strate that lower cervical canal is compressed from both anterior and posterior directions and clinical symptoms show severe neurological defects.