下颈椎损伤三种不同手术方式的临床研究进展

Progress of Clinical Research on Three Different Surgical Methods for Lower Cervical Spine Injury

摘要: 下颈椎损伤是暴力作用于颈椎运动复合体造成的严重损伤，常造成颈椎椎体及椎间盘韧带复合体(disco-ligamentous complex, DLC)严重破坏，骨性椎管变形并发生相对移位，椎管内脊髓或神经根常严重受损，神经功能恢复往往不理想。严重下颈椎损伤治疗的基本原则是充分的脊髓减压、恢复颈椎的正常序列及稳定性。由于下颈椎损伤类型繁多，对于下颈椎损伤有多种手术方式可供选择，但仍存在较大争议，尚未统一。我们采用手术内固定治疗下颈椎损伤，减少了褥疮、深静脉血栓形成、肺栓塞、肺部感染等并发症的发生，同时减少了疼痛等后遗症的发生；缩短住院时间，降低医疗费用，显著提高患者的生存及生活质量，是治疗下颈椎损伤的有效方法，值得临床应用推广。对于严重下颈椎损伤通过手术完成脊髓减压对恢复颈椎的稳定性、促进神经功能恢复十分重要。本文从手术方式选择对如何规范下颈椎损伤的手术治疗问题做了归纳总结。

Abstract: Lower cervical spine injury is a serious injury caused by violent action on the cervical motor com-plex, which often results in the serious destruction of the cervical vertebra and disc ligament com-plex (disco ligamentous complex, DLC), the deformation and relative displacement of the bony spi-nal canal, the spinal cord or nerve root in the spinal canal are often seriously damaged, and the re-covery of nerve function is often not ideal. The basic principles for the treatment of severe lower cervical spine injury are adequate spinal decompression and restoration of the normal sequence and stability of the cervical spine. Due to the various types of lower cervical injuries, there are a va-riety of surgical options for lower cervical injuries, but there is still a great deal of controversy and has not been unified. We used surgical internal fixation to treat lower cervical injury, which reduced the occurrence of complications such as bedsore, deep vein thrombosis, pulmonary embolism and pulmonary infection, and also reduced the occurrence of sequelae such as pain. Shortening hospital stay, reducing medical costs and significantly improving patients’ survival and quality of life are ef-fective methods for the treatment of lower cervical vertebra injury, worthy of clinical application and promotion. For severe lower cervical spine injuries, spinal decompression through surgery is very important to restore the stability of the cervical spine and promote the recovery of nerve func-tion. This paper summarizes how to standardize the surgical treatment of lower cervical spine inju-ry from the selection of surgical methods.