The Upper Traumatic Cervical Spinal Reconstructal Surgery

Objective:to analysis the operation's key points and indication during the uppertraumatic cervical spinal reconstructure.Methods 77cases who had suffered from the upper cervicalspinal diseases were treatedwith surgery in our hospital from 6.2004–12.2009.the occipitocervical fusion and fixation wasmade on 10 patients with atlatic fracture;the odontoid process screw fixation was made on 15patients with odontoid process fracture;the atlantoaxial pedical screw fixation was made on 8Patients with odontoid fracture accompanied with atlantoaxial instability;the axial Pedical screwfixation was made on 8 patients with Hangman fracture;anterior C2-3tai-plate fixation was madeon 5 patients with Hangman fracture;the atlantoaxial pedicle screw fixation and occipitocervicalfusion were separately made on 12 and 8 patients with atlantoaxial dislocation and instability;31cases with upper cervical spinal instability accompanied with spinal cord injurys were gradedaccording Frankel: odontoid process fracture with atlantoaxial instability E grade 6 cases,Dgrade 2 cases。atlantoaxial dislocation and instabilit E grade 5 cases,D grade 4 cases,C grade3 cases。C2-3 dislocation E grade 7 cases,D grade 4 cases。Patients were protected byNeck-protection for 1-3 months.Result all the patients were followed up for 3-24 months (averately 16 months ),anterior-posterial and laterial X-rays showed reduction restored and osseous fusion wereobstained after 3 months postoperatively.the nerve symptom improved in somedegree.Complication as followed:1 case with vertebral artery injury was used bone wax tohemostasis; 1 case with atlantoaxial laterial joint veinous sinus burst was compressed withsponge; 1 case with subcornoid injury was taken no-tention saturature and taken normal pressuredrainage ,no CSF leakage happened after surgery, 1 case with occipitocervical fusion and fixatinhappened with unilaterial screw rupture was taken it out after 1 year surgery. According clinicalperformance,self-feeling,functional restore,imagination evaluation: advantage 46 cases ,good25 cases, better 6 cases, advantage ratio 93.2℅.Conclusion During the upper cervical spinal reconstructal surgery ,surgery approachand internal fixation selection were based on injury,disease condition and technicallevel,meanwhile,not only adequate knowledging the upper cervical spinal local anatomy and biomechantic characters but also strictly mastering the surgery indication can reestabilish theupper cervical spinal stability safe and effectly.