| Objective:Through different operations in the treatment the Lower of cervical spine fracture and dislocation of clinical data analysis, discussion of the lower cervical spine fracture and dislocation of operation selection.Methods:Retrospective analysis of September 2006 to octuber 2009 hospital admitted 33 cases of the lower cervical spine fracture and dislocation of spinal cord injury patients with different surgical treatment of clinical data, according to the cervical spine injury and spinal cord compression parts of different is divided into three groups with different operations. Anterior group 19 cases (Centrum, disc anterior longitudinal ligament damage, such as spinal cord compression users) ahead, posterior group 9 cases (the vertebral fractures, the posterior longitudinal ligament damage, etc from the rear of the spinal cord compression), the combined set of 5 cases (spinal cord compression before and after party). Observate and record groups of blood loss, surgical time, Neural function recovery situations after surgery, the average amount of bleeding during surgery, the average time with spsslO software for data analysis, after the situation with JOA scoring and grading method Franke1 for comparison.Reslllts:All cases were obtained for follow-up, follow-up of 6 to 24 months, an average of 15 months, Intraoperative barely large vessels, trachea, esophagus, spinal cord injuries. the vast majority of bone gained bony fusion for 3 to 4 months after x-ray or CT examination. One of the anterior Group 1 cases after 1 week review x-ray shows titanium mesh offset, but without spinal cord injury leading to an increase,For reset the posterior and anterior to decompression and fixed, gained satisfactory bony fusion after 5 months. The remaining no plate breakage, screws loose and other complications, no false joints, nonUnion. Postoperative cervical intervertebral height and physiological curvature no loss. By comparing the three kinds of operation patients with surgical time, the amount of bleeding during operation Postoperative rehabilitation situation of neurological function, using the SPSS 10 software for analysis.the anterior operation time is significantly smaller than the posterior and anterior and posterior, there is a significant difference (P<0.05),Postoperative rehabilitation situation of neurological function, Different Surgical procedures for patients after scoring a preoperative JOA has improved(P<0.05), There are Significant differences in statistics. Various groups groups undergoing JOA score no obvious difference (P>0.05) For half a year after the spinal nerve function classification by Frankel. In addition to the complete spinal cord injury of two cases with no obvious recovery neural function, But the upper limb pain, numbness and tingling sensation had different degrees of mitigation Incomplete spinal cord injury patients with neurological function have varying degrees of recovery after half a year, The average increase for the series: Anterior group 1.3, posterior group 1.2, anterior and posterior group 1.0.Conclusion:1 To patients with the lower Cervical spine fracture and dislocation of spinal cord injury,the surgical treatment of the ultimate goal is to restore the cervical vertebrae under normal sequence, release the cervical spinal nerve root compression, to prevent an injury to nerve tissue secondary injury or re-injury, rehabilitation and reconstruction of the stability of the spine and As soon as early functional rehabilitation exercises under painlessness.2 Anterior or posterior surgery or Anterior and posterior combined,the three surgical attain the decompression, reset, and the reconstruction of spinal stability, recovery purposes such as spinal cord function, and each has advantages and disadvantages.3 Cervical spine fracture and dislocation of choice should be based on the type of the cervical spine injury, damage, injury, illness of different take different surgical approaches. |
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