中下位頚椎損傷に対する再建術再手術例の検討

概要

論文の詳細を見る
The purpose of this study was to analyze revision surgery for traumatic cervical injuries after unsuccessful stabilization and to discuss the indication for posterior instrumentation. Four hundred and one patients who sustained cervical injuries underwent either combined anterior-posterior or simple posterior reduction stabilized with posterior instrumentations. All patients were divided into three groups with respect to posterior instrumentation. There were 383 patients treated with interspinous process wiring and sandwich bone grafting, 6 patients had Luque sublaminar wiring and 12 had lateral mass plating. The cases which required revision surgery after failure of the first reconstructive surgery were investigated to assess the indication for posterior instrumentation based on the fact that the initial stabilization was unsucfessful. Of 383 patients treated with interspinous process wiring, only 6 patients (1.6%) required revision surgery. It was observed that lack of success in three of 4 of these patients was attributable to technical failure and in another to a lack of recognition of traumatic spondylolysis. No case with Luque sublaminar wiring needed revision surgery. Of 12 patients with lateral mass plating, two cases (16.7%) required revision. One was caused by a lack of recognition of traumatic spondylolysis and another by a weakness of the screw fixation. Considered from the fact that there was a very low revision rate after initial reconstructive surgery using posterior instrumentation, and also from the fact that there was a extreme low revision rate using less invasive interspinous process wiring, which was applied in 95% of cervical injuries, it is indicated that posterior instrumetation stabilization following our indication is appropriate for initial treatment of traumatic cervical instability. Facet articulation and spinous processes play an important role in stabilizing traumatized cervical spines using interspinous process wiring, but when they are destroyed, other posterior instrumentations have to be applied. Most traumatic cervical injuries were able to be treated successfully with less invasive interspinous process wiring and sandwich bone grafting. The procedure of posterior instrumetation stabilization should be considered as the first choice for treatment of traumatized cervical spines.
日本脊髄外科学会の論文
1999-03-31

中下位頚椎損傷に対する再建術再手術例の検討

スポンサーリンク

概要

著者

関連論文

スポンサーリンク