중하부 경추손상에서 후방 경추 내고정술 및 골유합술의 분석결과
Analysis of Posterior Cervical Fixation and Fusion in Subaxial Cervical Spine Injury
황성호, 송근성,
소속 상세정보
황성호 ( )
부산대학교 의과대학 신경외과학교실
송근성 ( )
부산대학교 의과대학 신경외과학교실
KMID : 0359820010300121388
Abstract
일측성 수두증은 여러가지 원인에 의해 발생될 수 있으나 주로 종양이나 감염등에 의한 후천적인 몬로공 폐쇄의 경우가 대부분이고 선천성 몬로공 폐쇄에 의한 일측성 수두증은 그 예가 많지 않다. 산전초음파 검사로 태아의 선천성 일측성 수두증을 진단했고 출산 후 수술적 방법을 통해 치료한 예는 국내에 아직 보고된 바가 없어 이를 문헌 고찰과 함께 보고한다.
Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine (C3-T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident (17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases.
Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14cases(81%) had kyphotic angle change less than 5° , 2 cases (12%) 5-20° , and 1 case (6%) more than 20°. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft.
Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary.
In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.
Subaxial cervical spine injury;Posterior fixation and fusion;Interspinous triple wiring;Lateral mass plating
키워드
원문 및 링크아웃 정보
등재저널 정보