上颈椎骨折脱位治疗进展

Advances in the Treatment of Upper Cervical Fractures and Dislocations

摘要: 上颈椎由寰椎(C1)和枢椎(C2)组成，二者通过独特的骨性结构(如齿突、侧块关节面)和韧带连接，形成寰枕关节和寰枢关节，分别负责头部的屈伸和旋转运动。该区域损伤主要指外力作用导致的枕–寰–枢复合体结构破坏，可表现为骨折、韧带损伤或关节脱位等病理改变，临床症状常见颈部疼痛、肢体瘫痪等，严重者可致死亡。鉴于其独特的解剖生理特点，不同损伤类型的临床表现和处理方式存在显著差异。目前主要损伤类型包括：寰枕关节脱位、寰椎骨折、枢椎骨折、寰枢关节脱位。随着科学技术的不断发展，基于损伤机制、分型及临床表现的研究不断深入，本文对其损伤的临床治疗新进展作系统性综述。

Abstract: The upper cervical spine is composed of the atlas (C1) and axis (C2), which are connected by unique bony structures (such as the dens and lateral mass articular surfaces) and ligaments, forming the atlanto-occipital and atlantoaxial joints, responsible for flexion-extension and rotational movements of the head, respectively. Injury to this region mainly refers to the structural damage of the occipito-atlanto-axial complex caused by external forces, which can manifest as fractures, ligament injuries, or joint dislocations, among other pathological changes. Clinical symptoms commonly include neck pain and limb paralysis; severe cases can lead to death. Given its unique anatomical and physiological characteristics, there are significant differences in the clinical manifestations and management of different injury types. The main injury types currently include atlanto-occipital dislocation, atlas fracture, axis fracture, and atlantoaxial dislocation. With the continuous development of science and technology, research based on injury mechanisms, classifications, and clinical manifestations is constantly deepening. This article systematically reviews new advances in the clinical treatment of these injuries.