CAJ | 학술논문

目的探讨下颈椎脱位合并小关节交锁患者的治疗方法选择. 方法颈椎脱位患者49例.损伤脱位节段:C3,4 7例,C4,5 15例,C5,6 14例,C6,7 13例,其中陈旧性脱位11例,病程2 h～61 d.脊髓损伤按Frankel分级:A级14例,B级9例,C级10例,D级9例,E级7例.所有患者均在颅骨牵引治疗试复位后进行手术治疗. 结果新鲜脱位患者牵引复位成功率63%,脊髓损伤平均改善0.65级.所有植骨块于术后4个月均获骨性融合.结论颈椎脱位患者的病情决定治疗方式,应根据患者脱位新鲜与否、是否截瘫、椎间盘的损伤的大小、经牵引是否可复位等来制订严密的手术计划,以最小的创伤恢复患者的健康.
목적 탐토하경추탈위합병소관절교쇄환자적치료방법선택. 방법경추탈위환자49례.손상탈위절단:C3,4 7례,C4,5 15례,C5,6 14례,C6,7 13례,기중진구성탈위11례,병정2 h～61 d.척수손상안Frankel분급:A급14례,B급9례,C급10례,D급9례,E급7례.소유환자균재로골견인치료시복위후진행수술치료. 결과신선탈위환자견인복위성공솔63%,척수손상평균개선0.65급.소유식골괴우술후4개월균획골성융합.결론 경추탈위환자적병정결정치료방식,응근거환자탈위신선여부、시부절탄、추간반적손상적대소、경견인시부가복위등래제정엄밀적수술계화,이최소적창상회복환자적건강.
Objective To discuss the therapeutic options for treatment of subaxial cervical dislocation combined with facet locking. Methods There were 49 patients with cervical dislocations including 7 patients with dislocation at C3,4, 15 at C4,5, 14 at C5,6 and 13 at C6,7. Eleven patients were with old dislocation, with duration of dislocation ranging from 2 hours to 61 days. Neurologic status of the patients according to Frankel scale was graded A in 14 patients, grade B in nine, grade C in 10 and grade D in nine. All patients were treated surgically after closed reduction with skull traction. Results The successful reduction rate was 63% for fresh dislocation, with average improvement of 0.65 grade for spinal cord function. All bone grafts got fusion at four months after operation. Conclusion Therapeutic options are based on fresh or old dislocations, paraplegia or not, intervertebral disk injury severity, and reduction or not through traction for patients with lower cervical dislocations.