摘要
目的探讨外伤性颈椎脱位的改良复位术式及应用价值。方法对24例外伤性颈椎脱位采用前入路撑开提拉复位并行植骨内固定。采用日本骨科协会评分(JOA)、疼痛视觉模拟评分(VAS)对术前和术后1周、3个月、6个月、12个月、48个月治疗效果进行评定。结果所有患者获得随访3~48个月,术后颈椎脱位矫正率、受损椎体间高度及颈椎稳定性恢复良好、颈椎生理曲度和内固定装置位置良好,植骨融合;脊髓功能恢复情况:B级2例,C级3例,D级10例,E级9例。术后1周~48个月VAS、JOA评分均较术前明显改善,差异有统计学意义(P<0.01)。结论前路撑开提拉复位法可早期对颈椎脱位进行有效复位,前路植骨内固定术后并发症少,减少受损神经细胞的死亡,进一步保护了神经功能,术后缩短了神经功能的恢复时间,适合临床推广应用。
Objective To investigate modified operation for traumatic cervical spine dislocation and its application value.Methods Anterior reduction by distraction and elevation, bone grafting and internal fixation were performed on 24 cases of traumatic cervical spine dislocation. The Japanese Orthopaedic Association(JOA) scoring system and visual analogue scale(VAS) were adopted to evaluate the preoperative conditions and the therapeutic effects at 1 week, 3 months, 6 months, 12 months and 48 months after operation. Results All patients were followed up for 3 to 48 months. The results demonstrated good correction rate of cervical spine dislocations, well recovered intervertebral disc heights and cervical curvatures and stabilities, internal fixation in good position, fusion of grafted bones, and spinal cord function recovery at level 1 to 3. VAS scores and JOA scores at 1 week to 48 months were markedly better than those before the operation( P <0.01). Conclusion Early reduction for cervical spine dislocation can be effectively achieved by anterior distraction and elevation and after the anterior bone grafting and internal fixation, only a few complications are present, and the deaths of damaged nerve cells are reduced, thus neurological function is further protected and postoperative recovery time of neurological function is shortened.The reduction method is suitable for clinical promotion and application.
出处
《中国骨与关节损伤杂志》
2015年第11期1127-1129,共3页
Chinese Journal of Bone and Joint Injury
关键词
颈椎脱位
前路
提拉复位
Cervical dislocation
Anterior approach
Reduction
