《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (11): 1068-1070.

• 临床研究 • 上一篇    下一篇

颅颈交界畸形外科治疗中辅助外固定支具的应用

刘策1; 余新光2; 周定标2; 伍刚1   

  1. 1.解放军总医院第二附属医院神经外科,北京市 100091;2.解放军总医院神经外科,北京市 100853
  • 收稿日期:2008-09-10 出版日期:2008-11-01 发布日期:2008-11-01

Application of External Orthosis for Surgical Treatment of Congenital Craniovertebral Malformation

LIU Ce, YU Xin-guang, ZHOU Ding-biao, et al   

  1. Department of Neurosurgery, The Second Affiliated Hospital of PLA General Hospital, Beijing 100091,China
  • Received:2008-09-10 Published:2008-11-01 Online:2008-11-01

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摘要： 目的探讨在颅颈交界畸形外科治疗中辅助外固定支具的选择和应用。方法回顾48例先天性颅颈交界畸形外科治疗中辅助外固定支具的应用,其中包括颈围、头环胸衣(Halo-vest)、胸骨-枕骨-下颔固定器(SOMI)3种颈部支具。结果后路内固定术后辅助外固定支具初选分别为费城式颈围(20例)、SOMI(16例)、头环胸衣(12例),应用效果优良率分别为80.0%、87.5%和91.7%。初选支具效果不满意者经更改支具后,最终在康复期应用的支具分别为费城式颈围16例、SOMI15例、头环胸衣17例35例(72.9%)获得了随访4个月以上,支具固定时间均超过3个月,满足所需术后支具外固定时间。结论颈围、头环胸衣、SOMI3种颈部支具在颅颈交界畸形外科治疗的围手术期和康复期的应用具有重要临床价值,需结合患者的病情特点和外科治疗不同阶段加以选择应用。

关键词: 颅颈交界畸形, 颈部支具, 颈胸支具

Abstract: Objective To investigate the effect of several types of cervical braces used for external immobilization on craniovertebral junction malformation. Methods 48 patients with craniovertebral junction malformation applied several types of cervical braces, including Philadelphia collar, sterno-occipito-mandibular immobilizer (SOMI) and Halo-vest, for the surgical treatment were retrospectively analyzed. Results The primary applications of external cervical brace after posterior internal craniovertebral fixation in this series were 20 cases of Philadelphia collar, 16 cases of SOMI and 12 cases of Halo-vest, with excellent or good results in 80%, 87.5% and 91.7%. The applications of external brace for post-hospital recovery were 16 cases of collar, 15 cases of SOMI and 17 cases of Halo-vest. 35 (72.9%) patients were followed-up for at least 4 months, with satisfying immobilization and duration which fulfilled the requirements for post-operative recovery. Conclusion The applications of the all of 3 kinds of external brace, including collar, SOMI and Halo-vest, have their important clinical value for peri-operational and post-operational recovery in the treatment of patients with craniovertebral junction malformation. To have a reasonable choice of these brace in different patients, the characteristics of pathology as well as the surgical stages should be taken into account.

Key words: craniovertebral junction malformation, cervical orthosis, cervical thoracic orthosis