伸展分离型颈椎损伤的诊断和治疗

目的 探讨伸展分离型颈椎损伤的诊断与治疗方法.方法 回顾性分析2000-2005年浙江大学医学院附属第二医院收治的56例伸展分离型颈椎损伤患者的临床表现和影像学资料,采取前路椎间盘切除或椎体次全切除、植骨内固定术治疗.结果 48例患者获得随访,随访时间6～17个月,平均11个月.9例完全性脊髓损伤患者术后5例有感觉功能改善,39例不完全性脊髓损伤患者术后13例完全恢复,其余均有不同程度改善.6例陈旧性损伤患者术后颈部疼痛消失,4例神经功能获得改善.结论 MRI是确诊伸展分离型颈椎损伤的最佳手段,早期前路椎间盘切除植骨内固定使颈椎获得稳定、促进神经功能恢复,是治疗伸展分离型颈椎损伤的理想方法.

Diagnosis and treatment for distractive extension injuries of the cervical vertebrae

Objective To study the diagnosis and treatment for distractive extension injuries of the cervical vertebrae.Method From 2000 to 2005.the clinical and image data of fifty-six patients in the Second Affiliated Hospital of Zhejiang University College of Medicine with distractive extension injuries of the cervical vertebrae were studied and treated with anterior discectomy or subtotal vertebrectomy in the second affiliated Hospital of zhejiang university collegeof medicine,bone grafting and internal fixation with plate.Results The follow-up period was six to seventeen months in fourty-eight patients.The neurological recovery was found after operation in five of nine case with complete spinal cord injuries and thirteen patient had complete recovery.Neck pain completely disappeared in 6 patients with oboslete injury and neurological recovery was improved in 4 patients.Condusions MRI examination is the essential approach to diagnoze distractive extension injuries of the cervical vertebran,and early operation,including anterior discectomy,bone graftillg and internal fixiation with plate,is a best choice of surgical interrention to achieve cervical stabilization and neurological improvement.