摘要
目的:探讨上颈椎损伤的分型以及外科治疗的临床效果。方法:2005年1月至2007年3月收治的16例创伤性上颈椎损伤患者,男11例,女5例;年龄24～75岁,平均44岁。其中齿状突骨折5例,寰椎骨折3例,Hangman骨折5例,寰枢椎脱位3例。颈椎MR检查:5例颈髓有不同程度受压和T2相高信号改变。根据其损伤机制、影像学表现、骨折分型选择合适的手术方式。结果:非手术治疗7例,手术治疗9例,均获随访,时间7～34个月,平均10.5个月。骨折均愈合或植骨融合,内固定无松动,未发生神经根椎动脉或脊髓损伤。结论:X线片、CT扫描及MR检查是上颈椎损伤必要的诊断措施,选择最佳的手术方式牢固固定上颈椎,同时又最大程度保留患者的颈椎活动度。
Objective ： To analyze retrospectively the clinical outcome of surgical management for upper cervical spine injury caused by trauma. Methods ： From January 2005 to March 2007,16 patients with injury of upper cervical spine were treated by different management. There were 11 males and 5 females with an average age of 44 years ranging from 24 to 75. Of all, 5 cases were the odontoid fracture, 3 were atlas fracture, 5 were Hangman＇s fracture, 3 were atlanto-axial dislocation. MR imaging of cervical spine showed cervical cord compression and changes of T2 high signal in 5 eases. According to the injury mechanism,the imageological appearance, fracture classification,the methods of treatment were selected. Results：Seven patients received non-operative treatment and nine patients underwent operation. Sixteen patients were followed up for 7 to 34 months （means 10.5 months）. All fractures were healing or bone graft fusion and no internal fixation was lossing. There were no injuries of vertebral artery, nerve root or spinal cord. Conclusion：CT and MRI are required in the course of diagnosis for the traumatic injury of upper cervical spine. The optimal modus operandi should be choose to retain upper cervical spine, meanwhile, can reserve the cervical movement.
出处
《中国骨伤》
CAS
2009年第5期387-388,共2页
China Journal of Orthopaedics and Traumatology
关键词
颈椎
骨折
脱位
外科手术
Cervical vertebrae
Fractures
Dislocations
Surgical procedures,operative
