CAJ | 학술논문

目的：探讨后路切开复位、椎弓根螺钉固定、椎板植骨治疗下颈椎骨折脱位伴关节突绞锁的疗效。方法26例下颈椎关节突绞锁中,单侧小关节绞锁者9例,双侧小关节绞锁者17例。患者入院后行颅骨牵引,3~5 d后行后路切开复位、椎弓根螺钉固定、椎板植骨术。对患者脊髓损伤ASIA神经功能评级,测量脱位程度,评价治疗效果。结果26例均获随访,时间12~36个月。术中无脊髓、血管、神经系统损伤；术后无螺钉松动,复位良好；颈椎椎间高度和生理曲度恢复。脊髓神经功能ASIA分级：2例A级、2例B级及1例C级患者无明显改善,其余病例较术前好转。结论后路切开复位、椎弓根螺钉固定、椎板植骨术是治疗下颈椎骨折脱位合并小关节绞锁的可行方法。
목적：탐토후로절개복위、추궁근라정고정、추판식골치료하경추골절탈위반관절돌교쇄적료효。방법26례하경추관절돌교쇄중,단측소관절교쇄자9례,쌍측소관절교쇄자17례。환자입원후행로골견인,3~5 d후행후로절개복위、추궁근라정고정、추판식골술。대환자척수손상ASIA신경공능평급,측량탈위정도,평개치료효과。결과26례균획수방,시간12~36개월。술중무척수、혈관、신경계통손상；술후무라정송동,복위량호；경추추간고도화생리곡도회복。척수신경공능ASIA분급：2례A급、2례B급급1례C급환자무명현개선,기여병례교술전호전。결론후로절개복위、추궁근라정고정、추판식골술시치료하경추골절탈위합병소관절교쇄적가행방법。
Objective To explore the clinical effects of the posterior open reduction and internal fixation for fracture and dislocation of cervical spine with cervical pedicle screws and vertebral plate bone graft and fusion. Methods 26 patients′clinical data with lower cervical facet fracture and dislocation locking were retrospectively analyzed. There were unilateral facet interlocking in 9 cases, bilateral locking in 17 cases. The skull traction-reduction was performed for 3~5 days,then all patients were treated by posterior open reduction,internal fixation with cervical pedicle screws, and laminar bone graft;Before the beginning of the treatment all patients were taken American Spinal Injury Associa-tion ( ASIA) neurological function grade and measured the degree of dislocation. Results The follow-up time of 26 cases ranged from 12 months to 36 months. There was no severe complication such as vertebral artery nerve root or spinal cord injuries or aggravation of spinal cord injury, and no screw loosening;All patients got good reduction, and restoration of intervertebral height. Neurofunction recovery was achieved in all cases except 2 cases with AISA A, 2 cases with AISA B and 1 case with AISA C. Conclusions Posterior open reduction, internal fixation and vertebral plate bone graft for fracture and dislocation of cervical spine with cervical pedicle screws is an effective method.