CAJ | 학술논문

目的：探讨前路手术治疗外伤性陈旧性下颈椎脱位疗效及可行性。方法对11例外伤所致的陈旧性下颈椎脱位患者进行前路减压椎间融合钢板内固定术，术前摄颈椎X线片，并作三维CT及颈椎MRI检查，了解骨折脱位及脊髓受压情况，术后摄颈椎X线片了解植骨融合、颈椎生理弧度恢复状况和内固定稳定性，并进行Frankel’s分级与术前比较改善程度。结果所有患者均获随访，随访期间8~39个月，平均23.4个月，术后功能Frankel’s分级均有改善，无术后神经损伤症状恶化、局部和全身并发症发生，固定节段稳定，颈椎生理性前突恢复并保持，内固定稳定，植骨愈合，无假关节形成。结论前路手术对治疗陈旧下颈椎脱位具有很好的临床疗效。严格掌握手术适应证、规范的手术操作、充分减压、牢固内固定，是手术成功的关键。
목적：탐토전로수술치료외상성진구성하경추탈위료효급가행성。방법대11예외상소치적진구성하경추탈위환자진행전로감압추간융합강판내고정술，술전섭경추X선편，병작삼유CT급경추MRI검사，료해골절탈위급척수수압정황，술후섭경추X선편료해식골융합、경추생리호도회복상황화내고정은정성，병진행Frankel’s분급여술전비교개선정도。결과소유환자균획수방，수방기간8~39개월，평균23.4개월，술후공능Frankel’s분급균유개선，무술후신경손상증상악화、국부화전신병발증발생，고정절단은정，경추생이성전돌회복병보지，내고정은정，식골유합，무가관절형성。결론전로수술대치료진구하경추탈위구유흔호적림상료효。엄격장악수술괄응증、규범적수술조작、충분감압、뢰고내고정，시수술성공적관건。
Objective To investigate the outcomes of the anterior-approach operation in treatment of lower cervical spine dislocation by a retrospective study. Methods Follow-ups were done for 11 successive patients who had been diagnosed as old lower cervical spine dislocation from February 2006 to August 2012 and undergone anterior-approach operation.All the patient had discectomy,auto-bone-graft fusion and plate-fixation. Preoperation plain X-ray,three-D CT and MRI were done to check the dislocation and compression on the spine cord,and postoperation plain X-ray to evaluate the fusion,the restitution of cervical lordosis,and the stability of intro-fixation.The clinical improvement was evaluated by Frankel’s grade. Results The mean period of follow-up was 26 months(from 8 to 37months).All the patients had substantial clinical improvement.No deterioration,or general or local complication happened.The fused segments were stable, and the retrieved cervical lordosis remained,and no nonunion happened.The intro-fixations were stable in all. Conclusion Treatment of old cervical spine fracture with anterior-approach operation has satisfactory results,as long as the indication are strictly followed,the cervical lordosis is restituted sufficiently,and intro-fixation are kept stable.