Surgical treatment is a generally accepted and widely used for lower cervical spine dislocation. However, there remains controversy and uncertainty over the best surgical approach. This study aimed to explore the clinical effect of anterior cervical surgery combined manipulative reduction on patients with lower cervical spine dislocation who failed in closed reduction. Retrospective analysis was performed on the clinical data of patients with lower cervical spine fracture and dislocation, as well as small joint noose, who were surgically treated between December 2013 and January 2015. The injured intervertebral disc segments were removed. Dislocated segments that could not be repositioned were subjected to manipulative reduction to facilitate the recovery of the zygapophysial joints and dislocated vertebral body in a normal physiological sequence. Segments that fail to reposition were subjected to surgery with posterior approach. Ten patients with failed closed reduction achieved complete reduction via anterior reduction and internal fixation with manipulative reduction. Six out of the 10 patients were improved by one American Spinal Injury Association (ASIA) grade, whereas the preoperative and postoperative ASIA scores in the other 4 patients remain the same. The average visual analog scale (VAS) scores were significantly reduced after surgery (P < 0.001). No aggravation of neurofunction and failure of internal fixation were observed in all patients. In conclusions, anterior cervical surgery with perioperative manipulative reduction can avoid unnecessary combined anterior-posterior surgery and is effective and safe approach for patients with lower cervical spine dislocation who failed in closed manipulative reduction or anterior distraction.

Objective To develop an autopsy table for the cervical surgery of the small animal to enhance the efficiency by regulating the angles during the operation to expose cervical vertebra adequately.Methods The autopsy table was composed of a table body,a head rack and a foot rack.The head rack was connected with the body by a loose-leaf shaft,which had a screw under a semi-cylindrical cushion put into a sliding slot of the cushion to regulate and fix its position.The table body had four straps at its comers to imobilize the extremities of the experimental animal,and some screws were used to adjust and position the straps to four oblique sliding slots.Results The autopsy table adapted itself to sizes of small animals,which gained advantages in exposure of operating field,short operating time,decreased intraoperative blood loss,head imobilization as well as reduced workload.Conclusion The autopsy table enhances surgery efficiency and safety and has easy operation and low cost,and thus is worthy promoting in the cervical experiment of small animals.

Objective To analyzed the digestive system management clinical application in pa-tients with cervical spine injury with paraplegia in perioperative period,retrospectively. Methods Analysis of Shanghai changzheng hospital spinal surgery in 2011-2013,84 patients with digestive system management mode of treatment of cervical vertebra trauma patients with paraplegia with clini-cal data,including age, gender,injury factors,cervical vertebra injured segments,operation situation, abdominal management methods and prognosis,statistical via abdomen symptom relief after processing. Digestive management of patients with paraplegia with cervical vertebra trauma,our methods are the nutrition support, fluid management,physical stimuli,effective purge and so on. Results Through perioperative effective digestive system managemen,67 patients’s abdominal symptoms eased in the varying degree,no one had colostomy. That method proved to improve the quality of life. Conclusion Reasonable and timely digestive system management can effectively reduce the cervical vertebra trauma patients with paraplegia with abdominal symptoms, improving quality of life of postoperative patients.

骨科亚学科的分化导致专业型增强。调查发现，脊柱外科研究生对脊柱激素损伤的基本概念、救治流程、预后判断和并发症防治掌握不足。教学组将损伤控制理念引入研究生的脊柱脊髓外伤教学中，帮助其把握该理念在临床应用中的适应证、熟知实际操作流程，对完成研究生期间的临床实践有明显的促进作用。

分析了骨科术后随访的重要性,采用摸底调查发现骨科研究生在术后随访中存在的不能持之以恒、形式单调、效率低下等问题,以案例教学、设计随访表、灵活使用随访方式、有效利用资料等方法进行针对性的教学,在教学中注意过程督导、医患沟通能力培养、医德教育等方面,取得了良好效果.

目的:测试后路板-棒内固定系统治疗不稳定寰椎骨折的稳定性,为临床使用提供理论基础.方法:采集新鲜成年人尸体颈椎骨(C0～C3)标本6具,用聚甲基丙烯酸甲酯(PMMA)上下包埋,在生物力学实验机上,以150N为最大生理载荷,最大力矩为1.50N·m,依次测量完整模型组(A组)、骨折模型组(B组,包括寰椎后弓两处骨折与典型Jefferson骨折,分别作为B1组和B2组,骨折模型制作时保持横韧带完整)、内固定模型组(C组,包括B1组+内固定系统、B2组+内固定系统,分别作为C1组、C2组)C0-C1、C1-C2节段前屈/后伸、左/右侧屈和左/右旋转等6个方向的三维运动范围(ROM),通过比较,评价后路板-棒内固定系统治疗寰椎骨折的生物力学稳定性.根据测量所得ROM值,设A组各方向三维运动稳定性指数(Sf)为100％,计算B组、C组模型各运动方向Sf,进一步直观比较各模型的稳定性变化.结果:C0-C1节段,A组前屈/后伸、左右侧屈、左右轴向旋转方向的ROM分别为11.06°±1.00°,7.08°±0.62°,13.24°±1.24°;B1、B2组前屈/后伸、左右侧屈、左右轴向旋转方向ROM均较A组明显增大(P＜0.05);C1组前屈/后伸、左右侧屈、左右旋转方向的ROM均较B1组明显减小(P＜0.05);C2组各方向ROM均较B2组明显减小(P＜0.05);C1、C2组前屈/后伸、左右侧屈、左右轴向旋转方向ROM与A组比较均无统计学差异(P＞0.05).C1-C2节段,A组前屈/后伸、左右侧屈、左右轴向旋转方向的ROM分别为10.07°±1.12°,5.56°±0.54°,20.83°±2.12°;B1、B2组各方向ROM均较A组明显增大(P＜0.05);C1组各方向的ROM较B1组明显减小(P＜0.05);C2组各方向ROM较B2组明显减小(P＜0.05);C1、C2组各方向ROM与A组比较均无统计学差异(P＞0.05).C0-C1节段,B1组前屈/后伸、左/右侧屈、左/右轴向旋转方向Sf分别为71％、70％、64％,B2组各方向Sf分别为61％、55％、58％,C1组各方向Sf分别为102％、108％、108％,C2组各方向Sf分别为91％、91％、92％.C1-C2节段,B1组前屈/后伸、左/右侧屈、左/右轴向旋转方向Sf分别为70％、61％、35％,B2组各方向Sf分别为59％、54％、37％,C1组各方向Sf分别为105％、111％、106％,C2组各方向Sf分别为91％、90％、92％.结论:寰椎后路板-棒内固定系统既能恢复上颈椎稳定性,又可保留其生理运动功能.使用该系统治疗寰椎后弓两处骨折,在稳定性方面效果稍优于典型Jefferson骨折.