CAJ | 학술논문

目的探讨Halo-vest支架复位联合前路减压内固定治疗下颈椎骨折脱位的临床疗效. 方法 2009年1月-2012年12月采用Halo-vest支架复位联合前路减压融合内固定治疗下颈椎骨折脱位患者26例,其中男18例,女8例;年龄19～64岁,平均42.1岁.致伤原因:交通伤11例,高处坠落伤9例,重物压砸伤6例.骨折脱位部位:C5/610例,C6/79例,C3/44例,C4/53例.行Halo-vest支架复位后再行前路减压融合内固定术.比较术前、术后神经功能改善情况.结果术后随访24 ～36个月,平均27.4个月.末次随访X线片及CT示骨折脱位均复位良好、植骨融合,无内固定松动或断裂.按Frankel分级:术前A级6例,B级8例,C级7例,D级3例,E级2例;术后A级5例,B级3例,C级4例,D级5例,E级9例.神经功能改善显效(降低2级)6例,有效(降低1级)13例,无变化7例(P＜0.05). 结论 Halo-vest支架复位联合前路减压内固定是安全可靠的治疗下颈椎骨折脱位的方法,值得临床推广.
목적 탐토Halo-vest지가복위연합전로감압내고정치료하경추골절탈위적림상료효. 방법 2009년1월-2012년12월채용Halo-vest지가복위연합전로감압융합내고정치료하경추골절탈위환자26례,기중남18례,녀8례;년령19～64세,평균42.1세.치상원인:교통상11례,고처추락상9례,중물압잡상6례.골절탈위부위:C5/610례,C6/79례,C3/44례,C4/53례.행Halo-vest지가복위후재행전로감압융합내고정술.비교술전、술후신경공능개선정황.결과 술후수방24 ～36개월,평균27.4개월.말차수방X선편급CT시골절탈위균복위량호、식골융합,무내고정송동혹단렬.안Frankel분급:술전A급6례,B급8례,C급7례,D급3례,E급2례;술후A급5례,B급3례,C급4례,D급5례,E급9례.신경공능개선현효(강저2급)6례,유효(강저1급)13례,무변화7례(P＜0.05). 결론 Halo-vest지가복위연합전로감압내고정시안전가고적치료하경추골절탈위적방법,치득림상추엄.
Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.