老年颈椎过伸性损伤治疗.docVIP

老年颈椎过伸性损伤治疗 　　[摘要] 目的:探讨老年颈椎过伸性损伤的治疗。方法:回顾1999年2月～2009年3月我院收治的28例老年颈椎过伸性损伤患者,随访观察近期及远期效果。结果:随访1～9年,19例手术治疗患者中,有3例行后路开门减压手术,3例行前路椎体次全切除髂骨块植骨融合内固定手术,7例行前路椎体次全切除钛网植骨融合钛板内固定+后路全椎板减压内固定,6例行后路全椎板切除减压内固定术。脊髓功能恢复程度按Frankel分级,其中,3例由A级恢复至C级,2例由A级恢复至D级,5例由B级恢复至D级,2例由C级恢复至D级,7例由C级恢复至E级。9例保守治疗的患者脊髓功能按Frankel分级,其中,1例仍为A级未恢复,3例由A级恢复至C级,1例由A级恢复至D级,2例由B级恢复至D级,2例由C级恢复至E级。结论:老年颈椎过伸性损伤患者的治疗过程复杂,需要考虑的问题很多,脊髓功能的恢复与脊髓损伤程度有关。除此以外,积极预防及治疗并发症、康复锻炼以提高生活质量是治疗过程中很重要的方面。 　　[关键词] 老年人;颈椎;脊髓损伤 　　[中图分类号] R681.5+3[文献标识码] B[文章编号] 1673-7210(2010)06(c)-145-03 　　 　　The treatment of hyperextension injury of the cervical spinal cord in the elderly adults 　　WANG Jiefeng, LI Guangrun, HAO Yongqiang, LIU Hongtao 　　(Department of Spinal Surgery, the Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China) 　　[Abstract] Objective: To discuss the treatment of hyperextension injury of the cervical spinal cord. Methods: 37 cases of hyperextension injury of the cervical spinal cord for elderly adults treated in our hospital were retrospectively analyzed, their recent and long-term effect were observed by follow-up. Results: After followed up for 1-9 years, in the 28 cases, 3 cases were performed the posterior decompression; 3 cases were performed cervical spine anterior decompression, flank bone grafting, fusion and internal fixators; 7 cases were performed cervical spine anterior plate system-plate with titanium mesh and posterior decompression; 6 cases were performed posterior whole laminectomy for decompression. There were 3 patients with Frankel grade A improved to grade C, 2 patients in grade A improved to grade D, 5 patients in grade B improved to grade D, 2 patients in grade C improved to grade D, 7 patients in grade C improved to grade E. In 9 conservative treatment cases, 1 patient in grade A did not improved, 3 patients in grade A improved to grade C, 1 patient in grade A improved to grade D, 2 patients in grade B improved to grade D, 2 patients in grade