| 摘要: |
| 目的总结Smith-Robinson入路(SR入路)应用于C2/3节段手术的经验。方法回顾性分析36例C2/3节段SR前路手术的患者资料,患者年龄21~72岁,平均(47±13.5)岁；男25例,女11例。其中Hangman骨折35例,C2/3创伤性椎间盘突出1例。合并伤包括颅脑外伤10例,面部软组织挫伤22例,腰椎骨折1例,四肢骨折6例,内脏挫裂伤2例；合并症包括强直性脊柱炎1例。结果36例均通过SR入路实施C2/3单节段手术,其中34例行Cage+前路钢板内固定,2例行自体髂骨块+前路钢板内固定。所有手术均顺利完成。随访6~32个月,平均随访时间(9.1±2.8)个月。1例(2.4%)患者术后出现饮水呛咳,3个月后自行消失。术前10例患者有不同程度神经功能障碍,术前Japanese Orthopaedic Association Scores(JOA)评分13.10±3.35,术后JOA评分15.70±1.49,改善率(74±23)%。所有患者均获得植骨融合。 结论SR入路可用于C2/3节段手术,具有操作简便、局部解剖清晰、并发症少等优点；但下颌骨大、肌肉健壮的患者采用这一入路有一定困难。 |
| 关键词: 颈椎；前路；Smith-Robinson入路 C2/3颈椎手术 |
| DOI：10.3724/SP.J.1008.2012.001199 |
| 投稿时间：2012-05-23修订日期：2012-07-01 |
| 基金项目: |
|
| Application of Smith-Robinson approach for C2/3 cervical spine surgery |
| ZHANG Ying,MA Jun,CHEN Yuan-yuan,WANG Xin-wei,CHEN De-yu,YUAN Wen* |
(Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author.) |
| Abstract: |
| Objective To summarize our experience in using Smith-Robinson approach (SRA) for level C2/3 cervical spine surgery. Methods The clinical data of 36 patients receiving SRA for level C2/3 cervical spine surgery were retrospectively analyzed. The patients included 25 males and 11 females, with an average age of (47±13.5) years(range: 21-72 years). Thirty-five cases had Hangman fracture and one had traumatic disc herniation at C2/3. Combined injury included head injury (10 cases), soft tissue injury on the face (22 cases), fracture at lumbar spine (1 case), extremities fracture (6 cases) and injury of inner organs (2 cases). One patient had ankylosing spondylitis. Results C2/3 discetomy procedures were performed satisfactorily in all the 36 cases, with cages plus anterior plate fixation used in 34 cases and iliac bone plus anterior plate fixation in 2 cases. The patients were followed up for (9.1±2.8) months (ranging 6-32 months). One patient (2.4%) had choking and trouble in swallowing liquids, and the symptom disappeared 3 months later without any treatment. Neurological dysfunction was observed in 10 cases before operation, with the average JOA scope being (13.10±3.35) pre-operation and (15.70±1.49) post-operation, showing an improving rate of (74±23)%. Fusion was achieved in all cases during follow-up. Conclusion SRA can be applied at level C2/3 cervical spine surgery; the procedure is simple, with clear surgical field and less complication. Patients with large chin or extremely strong muscle may not be indicated for this approach. |
| Key words: cervical vertebrae anterior approach Smith-Robinson approach C2/3 cervical spine surgery |
