前后联合入路手术治疗急性创伤性下颈椎损伤24例

目的探讨严重下颈椎损伤的机制及前后联合入路手术的治疗效果。方法回顾性分析2007年4月至2011年4月收治的24例严重颈脊髓损伤患者,根据损伤类型,采取前-后或后-前两种不同的联合入路术式治疗。以ASIA分类标准进行分级,观察手术前后脊髓功能的变化,以评价其临床疗效。结果术后1例死亡。23例获随访,随访时间11～59个月,平均29个月。23例全部获椎间融合,脊髓功能均有不同程度恢复。结论严格掌握前后联合入路治疗急性下颈椎损伤的手术适应证,减压彻底,可获得良好的颈椎稳定性,有利于脊髓功能恢复。

Anterior and posterior approaches in treatment of 24 patients with acute traumatic lower cervical injury

Objective To explore the mechanism of severe traumatic lower cervical injury and the treatment efficacy of anterior and posterior approaches.Methods From April 2007 to April 2011,24 patients suffering from lower cervical spinal injury were involved in this retrospective study.According to the type of injury,anterior-posterior operation or posterior-anterior operation were conducted.The changes of spinal function between preoperative and postoperative were observed by ASIA standards to assess the efficacy.Results One patient died after operation.The follow-ups averaged 29 months(from 11 to 59 months).Intervertebral fusion was observed in all patients.All cases of spinal cord function had different levels of recovery.Conclusion Anterior and posterior approach can decompress the lower cervical spine completely,restore the normal alignment and stability of the cervical spine immediately,and improve the spinal nervous function effectively,when the surgeons control the indications strictly.