| 创伤性上颈椎损伤的外科治疗 |
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Received:January 15, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李柳炳 |
LI Liu-bing |
苏州大学附属第二医院骨科,江苏 苏州 215004 |
Department of Orthopaedics,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,Jiangsu,China |
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| 沈忆新 |
SHEN Yi-xin |
苏州大学附属第二医院骨科,江苏 苏州 215004 |
Department of Orthopaedics,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,Jiangsu,China |
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| 范志海 |
FAN Zhi-hai |
苏州大学附属第二医院骨科,江苏 苏州 215004 |
Department of Orthopaedics,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,Jiangsu,China |
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| 张鹏 |
ZHANG Peng |
苏州大学附属第二医院骨科,江苏 苏州 215004 |
Department of Orthopaedics,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,Jiangsu,China |
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| 王璐璐 |
WANG Lu-lu |
苏州大学附属第二医院骨科,江苏 苏州 215004 |
Department of Orthopaedics,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,Jiangsu,China |
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| 期刊信息：《中国骨伤》2009年22卷，第5期，第387-388页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨上颈椎损伤的分型以及外科治疗的临床效果。
方法：2005年1月至2007年3月收治的16例创伤性上颈椎损伤患者，男11例，女5例；年龄24～75岁，平均44岁。其中齿状突骨折5例，寰椎骨折3例，Hangman骨折5例，寰枢椎脱位3例。颈椎MR检查：5例颈髓有不同程度受压和T 2相高信号改变。根据其损伤机制、影像学表现、骨折分型选择合适的手术方式。
结果：非手术治疗7例，手术治疗9例，均获随访，时间7～34个月，平均10.5个月。骨折均愈合或植骨融合，内固定无松动，未发生神经根椎动脉或脊髓损伤。
结论：X线片、CT扫描及MR检查是上颈椎损伤必要的诊断措施，选择最佳的手术方式牢固固定上颈椎，同时又最大程度保留患者的颈椎活动度。 |
| [关键词]:颈椎 骨折 脱位 外科手术 |
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| Surgical management of traumatic injury of upper cervical spine |
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Abstract:
Objective: To analyze retrospectively the clinical outcome of surgical management for upper cervical spine injury caused by trauma.
Methods: From January 2005 to March 2007,16 patients with injury of upper cervical spine were treated by different management. There were 11 males and 5 females with an average age of 44 years ranging from 24 to 75. Of all,5 cases were the odontoid fracture,3 were atlas fracture,5 were Hangman's fracture,3 were atlanto-axial dislocation. MR imaging of cervical spine showed cervical cord compression and changes of T2 high signal in 5 cases. According to the injury mechanism,the imageological appearance, fracture classification,the methods of treatment were selected.
Results: Seven patients received non-operative treatment and nine patients underwent operation. Sixteen patients were followed up for 7 to 34 months(means 10.5 months). All fractures were healing or bone graft fusion and no internal fixation was lossing. There were no injuries of vertebral artery,nerve root or spinal cord.
Conclusion: CT and MRI are required in the course of diagnosis for the traumatic injury of upper cervical spine. The optimal modus operandi should be choose to retain upper cervical spine,meanwhile,can reserve the cervical movement. |
| KEYWORDS:Cervical vertebrae Fractures Dislocations Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李柳炳,沈忆新,范志海,张鹏,王璐璐.创伤性上颈椎损伤的外科治疗[J].中国骨伤,2009,22(5):387~388 |
| 英文格式: | LI Liu-bing,SHEN Yi-xin,FAN Zhi-hai,ZHANG Peng,WANG Lu-lu.Surgical management of traumatic injury of upper cervical spine[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(5):387~388 |
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