平乐正骨手法在下颈椎骨折脱位复位中的作用
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摘要
目的:探讨平乐正骨手法在下颈椎骨折脱位复位中的作用。方法:回顾性分析2014年1月至2016年3月,在下颈椎骨折脱位复位时采用平乐正骨手法治疗35例患者资料。结果:患者顺利完成手术,切口均愈合良好。35例患者术中透视见复位成功。患者均获得随访,随访时间6-36个月,平均为15个月。最后一次随访时对所有患者进行神经功能评分,A级6例,B级7例,C级6例,D级10例,E级6例,1例患者术后颈部时有僵硬疼痛感,未发生脊髓神经根损伤或脊髓损伤加重等严重并发症。结论:下颈椎骨折脱位患者采用平乐正骨手法治疗,有利于脱位复位。
Objective:To explore the effects of Pingle bone-setting manipulation in the reduction of subaxial cervical fracture-dislocation.Methods:The data of 35 patients treated with Pingle bone-setting manipulation between January 2014 and March 2016 were included.Results:The patients successfully completed the operation and the incision healed well.A total of 35 patients with intraoperative fluoroscopy showed a successful reduction.Patients were followed for 6 months to 36 months,the average was 15 months.All patients were rated for neurological functionin the last follow-up visit,there were 6 cases in level A,7 in level B,6 in level C,10 in level D,6 in level E according to ASIA scale.One patient was with severe pain in the postoperative neck,but without serious complications such as spinal cord injury or severe spinal cord injury.Conclusion:The use of Pingle bone-setting manipulation is conducive in the reduction of subaxial cervical fracture-dislocation.
Objective:To explore the effects of Pingle bone-setting manipulation in the reduction of subaxial cervical fracture-dislocation.Methods:The data of 35 patients treated with Pingle bone-setting manipulation between January 2014 and March 2016 were included.Results:The patients successfully completed the operation and the incision healed well.A total of 35 patients with intraoperative fluoroscopy showed a successful reduction.Patients were followed for 6 months to 36 months,the average was 15 months.All patients were rated for neurological functionin the last follow-up visit,there were 6 cases in level A,7 in level B,6 in level C,10 in level D,6 in level E according to ASIA scale.One patient was with severe pain in the postoperative neck,but without serious complications such as spinal cord injury or severe spinal cord injury.Conclusion:The use of Pingle bone-setting manipulation is conducive in the reduction of subaxial cervical fracture-dislocation.
引文
[1]郭维淮.平乐正骨郭维淮.北京:人民卫生出版社,2008:13-14
[2]Waring W P 3rd,Biering-Sorensen F,Burns S,et al.Looq review and revisions of the international standards for the nemrological classification of spinal cord injury.J Spinal lord Med,2010,33(4):346-352
[3]Eismont F J,Arena M J,Green B A.Extrusion of an intervertebral disc associated with traumatic subluxation or dislocation of cervical facets Case report.J Bone Joint Surg Am,1991,73(10):1555-1560
[4]Rizzolo S J,Piazza M R,Cotler J M,et al.Intervertebral disc injury complicating cervical spine trauma.Spine,1991,16(6 suppl):187-189
[5]Ordonez B J,Benzel E C,Naderi S,et al.Cervical facet dislocation:techniques for ventral reduction and stabilization.Journal of Neurosurgery,2000,92(1 suppl):18
[6]Grant G A,Mirza S K,Chapman J R,et al.Risk of early closed reduction in cervical spine subluxation injuries.J Neurosurg,1999,90:13-18
[7]Anderson D G,Voets C,Ropiak R,et al.Analysis of patient variables affecting neurologic outcome after traumatic cervical facet dislocation.Spine J,2004,4(5):506-512
[8]袁文,贾连顺.前路手术治疗严重下颈椎骨折脱位.中国脊柱脊髓杂志,2001,11(1):23-25
[9]Alam N,Haque M R,Kamaluddin M,et al.Cervical spine injury:experience with 82 cases.International Congress,2002,1247(2):591-596
[10]Kang J D.Unilateral and bilateral facet fractures and dislocations of the subaxial spine.Current Opinion in Orthopaedics,1997,8(2):33-40
[11]Vaccaro A R,Falatyn S P,Flanders A E,et al.Magnetic resonance evaluation of the intervertebral disc,spinal ligaments,and spinal cord before and after closed traction reduction of cervical spine dislocations.Spine,1999,24(12):1210-1217
[12]Bilston L E,Thibault L E.The mechanical properties of the human cervical spinal cord in vitro.Annals of Biomedical Engineering,1995,24(1):67-74
[13]Yuan Q,Dougherty L,Margulies S S.In vivo human cervical spinal cord deformation and displacement in flexion.Spine,1998,23(23):1677-1683
[14]Miller L S,Cotler H B,De Lucia F A,et al.Biomechanical analysis of cervical distraction.Spine,1987,12(9):831-837
[15]Onan O A,Heggeness M H,Hipp J A.A motion analysis of the cervical facet joint.Spine,1998,23(4):430-439
[16]赵明宇,杨超凡.泰庆广,等.平乐正骨“筋滞骨错”理论指导下手法治疗冻结肩的临床研究.中华中医药杂志,2017,32(8):3846-3848
[17]周英杰,柴旭斌,郑怀亮,等.前路撑开撬拨复位固定治疗下颈椎骨折脱位伴关节突绞锁的效果.中华创伤杂志,2016,32(11):1002-1008
[2]Waring W P 3rd,Biering-Sorensen F,Burns S,et al.Looq review and revisions of the international standards for the nemrological classification of spinal cord injury.J Spinal lord Med,2010,33(4):346-352
[3]Eismont F J,Arena M J,Green B A.Extrusion of an intervertebral disc associated with traumatic subluxation or dislocation of cervical facets Case report.J Bone Joint Surg Am,1991,73(10):1555-1560
[4]Rizzolo S J,Piazza M R,Cotler J M,et al.Intervertebral disc injury complicating cervical spine trauma.Spine,1991,16(6 suppl):187-189
[5]Ordonez B J,Benzel E C,Naderi S,et al.Cervical facet dislocation:techniques for ventral reduction and stabilization.Journal of Neurosurgery,2000,92(1 suppl):18
[6]Grant G A,Mirza S K,Chapman J R,et al.Risk of early closed reduction in cervical spine subluxation injuries.J Neurosurg,1999,90:13-18
[7]Anderson D G,Voets C,Ropiak R,et al.Analysis of patient variables affecting neurologic outcome after traumatic cervical facet dislocation.Spine J,2004,4(5):506-512
[8]袁文,贾连顺.前路手术治疗严重下颈椎骨折脱位.中国脊柱脊髓杂志,2001,11(1):23-25
[9]Alam N,Haque M R,Kamaluddin M,et al.Cervical spine injury:experience with 82 cases.International Congress,2002,1247(2):591-596
[10]Kang J D.Unilateral and bilateral facet fractures and dislocations of the subaxial spine.Current Opinion in Orthopaedics,1997,8(2):33-40
[11]Vaccaro A R,Falatyn S P,Flanders A E,et al.Magnetic resonance evaluation of the intervertebral disc,spinal ligaments,and spinal cord before and after closed traction reduction of cervical spine dislocations.Spine,1999,24(12):1210-1217
[12]Bilston L E,Thibault L E.The mechanical properties of the human cervical spinal cord in vitro.Annals of Biomedical Engineering,1995,24(1):67-74
[13]Yuan Q,Dougherty L,Margulies S S.In vivo human cervical spinal cord deformation and displacement in flexion.Spine,1998,23(23):1677-1683
[14]Miller L S,Cotler H B,De Lucia F A,et al.Biomechanical analysis of cervical distraction.Spine,1987,12(9):831-837
[15]Onan O A,Heggeness M H,Hipp J A.A motion analysis of the cervical facet joint.Spine,1998,23(4):430-439
[16]赵明宇,杨超凡.泰庆广,等.平乐正骨“筋滞骨错”理论指导下手法治疗冻结肩的临床研究.中华中医药杂志,2017,32(8):3846-3848
[17]周英杰,柴旭斌,郑怀亮,等.前路撑开撬拨复位固定治疗下颈椎骨折脱位伴关节突绞锁的效果.中华创伤杂志,2016,32(11):1002-1008