目的：探讨颈椎前路骨折块复位，颈2-3椎间盘切除、椎间融合术治疗枢椎泪滴样骨折的临床效果。方法2007-07-2010-07在我科行前路手术治疗的枢椎泪滴样骨折患者共23例，男18例，女5例；年龄25～59岁，平均39.6岁。手术方式均为颈前路颈2-3椎间盘切除椎间植骨融合内固定术。采用ASIA感觉运动功能评分及视觉模拟疼痛量表（VAS）对患者的临床效果进行测评。结果术后3个月和12个月随访ASIA感觉运动功能评分，优良率均达到85.71%，与术前相比较有显著性差异。术后随访时段VAS评分较术前均有明显改善，与术前相比较有显著性差异。术后X线片示骨折块脊柱融合率达到100%。结论前路手术治疗枢椎泪滴样骨折不仅创伤小，出血少，而且彻底切除受损的椎间盘，并行椎间融合内固定恢复了枢椎的正常序列和前纵韧带的连续性，重建了最为重要的前柱稳定，消除椎间不稳的因素，临床效果满意。%Objective To study the clinical effects of anterior cervical approach,reduction of fracture fragments,discectomy and interbody fusion of C2-3 in the treatment of axial tear-drop frac-ture. Method From July 2007 to July 2010,a total of 23 patients with C2-3 tear-drop fracture were retrospectively enrolled and were treated with anterior cervical approach. There were 18 males and 5 females,the age was ranged from 25 to 59 years old (average 39.6 years old). All patients were treated with anterior cervical approach,reduction of fracture fragments,discectomy and inter-body fusion. The recovery rate was calculated using preoperative and postoperative ASIA scores for each patient,and VAS was also measured. Results The VAS and ASIA scores were all improved postoperative 3 and 12 months,the recovery rate is 85.71%,and the differences were significant compared with preoperation. X-ray image after operation showed the anatominc reduction of 18 cas-es,the rotary and dislocation was almost reducted in 5 cases. All of the internal fixation had a satisfactory position and no loose or broken of the internal fixation system was found during follow-up. The rate of fusion was 100%. Conclusion The application of anterior cervical approach in the treatment of axial tear-drop fracture not only can reduce injury and bleeding,but also can conduct satisfactory discectomy and interbody fusion. And anterior cervical approach,reduction of fracture fragments,discectomy and interbody fusion of C2-3 in the treatment of axial tear fracture has satis-factory clinical results.
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