术中颅骨牵引与撬拨复位治疗下颈椎单节段关节突绞锁

发布时间：2018-08-31 21:01

【摘要】：[目的]总结应用ACDF联合术中颅骨牵引助推撬拨技术治疗下颈椎单节段关节突绞锁的临床效果。[方法]采用ACDF联合术中颅骨牵引助推撬拨技术治疗30例单节段下颈椎关节突绞锁患者,记录关节突关节复位所需时间、手术时间、出血量等,并定期复查X线片及CT,通过测量椎间隙高度及Bridwell椎间融合标准评估椎间植骨融合情况,根据ASIS评级分析手术前后神经功能,根据JOA评分评估脊髓功能恢复情况。[结果]30例患者均手术顺利,关节突关节复位所需时间(2±1)min,手术时间(45±8)min,术中失血(30±5)ml。术后影像检查显示伤段100%复位,融合良好,椎体间隙高度增加。除3例患者外,其他患者术后1个月时ASIA评级显著改善。与术前相比较,术后3个月JOA评分明显改善。[结论]应用ACDF联合术中颅骨牵引助推撬拨技术能够在短时间内使关节突绞锁复位,挽救脊髓功能,长期可保持椎间高度和脊柱正常序列,椎间融合可靠,操作简单。
[Abstract]:Objective: to summarize the clinical effect of ACDF combined with skull traction and prying technique in the treatment of lower cervical spine single segment articular process strangulation. [methods] 30 patients with single segment lower cervical spine process strangulation were treated with ACDF combined with cranial traction and prying technique. The time required for reduction of articular process joint, operative time, and blood loss were recorded. X-ray films and CT, were used to evaluate the intervertebral fusion by measuring the height of intervertebral space and the standard of Bridwell intervertebral fusion. The neurological function before and after operation was analyzed according to ASIS rating and the recovery of spinal cord function was evaluated according to JOA score. [results] all the 30 patients underwent successful operation, and the time of reduction of articular facet joint was (2 卤1) min, operation time (45 卤8) min, operation blood loss was (30 卤5) ml.. Postoperative imaging showed 100% reduction, good fusion and increased height of vertebral space. With the exception of 3 patients, the ASIA rating improved significantly 1 month after operation. Compared with preoperative, JOA scores were significantly improved 3 months after operation. [conclusion] the technique of ACDF combined with skull traction and prying during operation can reduce the articular process strangulation in a short time, save the spinal cord function, maintain the intervertebral height and the normal sequence of the spine for a long time, the intervertebral fusion is reliable and the operation is simple.
【作者单位】：郑州市骨科医院脊柱外科;
【分类号】：R687.3

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