The Early Diagnosis And Therapy Of Lower Cervical Spine Injury

Backgrounds : Lower cervical spine injury is C3～7 centrum vertebrae .The fracture and dislocation of the lower cervical spine is very common in lower cervical spine injury, With the majority of them young adults. With the development of industrial transportation and sports, Young and the elderly are growing cervical spine injury. Depends on the cause of cervical spine injury by forcing injured in the instant posture, posture, as well as outside the nature, modalities and time role. Damage to the stability of conservative therapy, which generally take the traction or brace, gypsum fixed. The instability of the injury, especially the lower cervical spine fractures and dislocations, with spinal abnormalities, could be consolidated fractures, frequently accompanied with the spinal cord injury, or even life-threatening. To resumpt the normo-sequence of cervical spine, decompress thoroughly, resumpt vertebra altitude and curvature of cervical spine and obtained instantly stability of cervical spine is the basic principle of the treatment of FDLCS. Reducing early to relief the oppression of the spinal cord is the key point of the treatment .Objective:To delineate the diagnosis and therapy of the lower cervical injury by analysing patients with the injury retrospectivelyMethods:30 lower cervical injury managed between 2001～2005 at our department were involved, 22 male and 8 female, the average age was 28.8(19-57).The mechanisms of injure to the lower cervical injury included 12 traffic accidents injure,2 fall injure,14 crash injure and 2 others injure. The location of the injury : 1 case was C3 fracture, 2 cases were C4 fracture and 3 cases were C5 fracture, 6 cases were C6 fracture, 1 case was C4 and C5 fracture, 4 cases were C4 fracture and dislocation , 7 cases were C5 fracture and dislocation, 5 cases were C6 fracture and dislocation, 4 cases were C7 fracture and dislocation .According to the Allen standard, 20 cases were compressive flexion,5 cases were vertical compression, 2cases were compressive extension,3 cases were distractive flexion. vertebral body tumor;1 case with tuberculosis of cervical vertebrae . The followed-up period ranged from 3 months to 24 months, the average period of followed-up was 18 months. According to the Frankel standard of spinal cord function, 3 cases were A, 8 cases were B, 10 cases were C, 9 cases were D. 16 cases were disci intervertebrales injury. 19 cases were incomplete paralysis, 11 cases were complete paralysis. All the cases were divided into two groups, A group of 18 cases of surgery for early (24 hours), B 12 cases of elective surgery (after injury five days to three months), of which three cases of cervical fracture and dislocation for the merger of brain injury, Three cases of abdominal injury, two cases of chest injuries, seven cases of cervical fracture and dislocation for the conservative treatment after cervical instability.result: All vertebral dislocation be reduced, the reconstruction of cervical stability. 3 cases Frankel A nerve function in patients with 1 case of back to class B, no restoration of the remaining 1 cases, B, C, D ,27 cases were Franke1 improve 1 to 2. Score after two groups of nerve function compared, A and B group after surgery than before were improved;A group of improvement is better than group B (P <0.01). This shows that the early operation of the Group of functional recovery than elective surgery group.conclusion:1.Quick and correct early diagnosis and treatment after cervical vertebrae injury are the key steps in decreasing the death rate and disability rate.2.To resumpt the normo-sequence of cervical spine, decompress thoroughly, resumpt vertebra altitude and curvature of cervical spine and obtained instantly stability of cervical spine is the basic principle of the treatment of lower cervical injury. Reducing early to relief the oppression of the spinal cord is the key point of the treatment .3.Early surgical treatment for the timely resumption of height and spinal cage capacity, the timely lifting of spinal cord compression, reconstruction of cervical stability and conducive to early postoperative training, promotion of functional recovery.