创伤性颈椎不稳定病变的独立前路重建方法

K. Kenawy, Amr M. Tayel, A. Abdelhameid
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引用次数: 0

摘要

背景:与脊髓损伤相关的颈椎下轴外伤具有很高的发病率和死亡率,并对社会经济产生重大影响。治疗此类病例的方法多种多样。目的评估在治疗伴有脊髓压迫的移位性亚轴向颈椎损伤时,独立前路重建颈椎手术与椎笼和椎板系统的早期疗效。患者和方法:研究纳入了 2020 年 1 月至 2024 年 1 月期间 14 例移位性颈椎轴下损伤伴脊髓压迫的患者。这些患者均接受了独立的颈椎前路重建手术,并使用笼和板系统治疗其病变,所有患者的术前症状和术后结果均被记录在案。结果患者中有 9 名男性和 5 名女性,平均年龄为 28 岁。最常见的颈椎水平是 C5-C6,占 10 例(71.5%),其次是 C4-C5 3 例(21.5%),然后是 C6-C7(7 例)。术中平均失血量为 150 毫升 ± 50 毫升。最常见的并发症是 4 例 C5 麻痹,经药物治疗和随访后好转。该系列手术未报告 CSF 渗漏、硬件故障、血管损伤或软组织损伤。结论在全身麻醉下对颈椎轴下脱位进行术中即刻闭合复位,同时使用颈椎笼和钢板系统进行颈椎前路稳定,因其安全性高、有效率高、并发症少,已被证明是首选的治疗方案。
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Standalone Anterior Reconstruction Approach in Traumatic Cervical Spine Instability Lesions
Background: The subaxial cervical spine trauma associated with spinal cord injury carries high rate of morbidity, mortality, with significant socioeconomic impact. There are different modalities for treatment of such cases. Objective: To evaluate the early outcome of standalone anterior reconstruction cervical spine surgery with cage and plate system in management of displaced subaxial cervical spine injuries with cord compression. Patients and Methods: The study included 14 patients during the period from January 2020 to January 2024 with displaced subaxial cervical spine injuries associated with cord compression. Preoperative symptoms and postoperative results for those patients who underwent standalone anterior reconstruction of cervical spine by surgery with cage and plate system for treatment of their lesions, were all recorded. Results: Patients were 9 males and 5 females with mean age 28 years. The most common cervical level affected was C5-C6 accounting for (71.5%) 10 cases, followed by C4-C5 3 cases (21.5%) then C6-C7 (7 case). The average blood loss intraoperatively was 150 ml ± 50. The most common complication was the C5 palsy occurred in 4 cases who improved with medical treatment and follow up. No CSF leak, hardware failure, vascular injury or soft tissue injuries were reported in this series. Conclusion: Performing immediate intraoperative closed reduction under general anesthesia for subaxial cervical spine dislocations, along with anterior cervical stabilization using a cage and plate system, has been shown to be the preferred treatment option due to its high safety and efficacy rates, with fewer complications.
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