无骨折脱位型颈髓损伤的手术治疗方式探析  

Investigation of surgical treatment method for cervical spinal cord injury without fracture and dislocation

作　　者：刘杨[1] 舒勇[1] 余凯龙 温晓阳 

机构地区：[1]南昌大学第一附属医院骨科,南昌330006 [2]江西省新余市人民医院骨一科,江西新余338000

出　　处：《中国当代医药》2015年第22期65-69,共5页China Modern Medicine

基　　金：江西省新余市科技局立项课题(20143090859)

摘　　要：目的探讨无骨折脱位型颈髓损伤合适的手术方式。方法选取江西省新余市人民医院2011年1月~2014年5月骨科收治行手术治疗的无骨折脱位型颈髓损伤并获得随访的患者31例,根据手术方式分为颈前路组和颈后路组,随访时间5~48个月,评估其术中出血量、术后引流量、内固定费用、术前术后脊髓功能的Frankel分级及JOA评分并进行统计学分析。结果颈后路组的术中出血量、术后引流量均显著多于颈前路组,内固定费用高于颈前路组（P〈0.05）;颈前、后路组术前术后的Frankel等级差异有统计学意义（P=0.0015,0.0061）;术前术后的JOA评分差异有统计学意义（P=0.0008,0.0061）。结论颈椎前路和后路手术在无骨折脱位型颈髓损伤的治疗效果无明显差异,但是在手术创伤、术后引流量、内固定费用方面,前路组显著优于后路组。Objective To explore the appropriate surgical way of cervical spinal cord injury without fracture and dislo-cation. Methods 31 patients with cervical spinal cord injury without fracture and dislocation admitted into department of orthopedics in Xinyu People’s Hospital of Jiangxi Provice and given follow-up from March 2011 to May 2014 were selected and they were divided into cervical anterior approach group and cervical posterior approach group according to surgical way.The follow-up time was 5-48 months.Volume of bleeding during surgery,postoperative drainage volume,in-ternal fixation cost,Frankel grade and JOA score of pre-operative and postoperative spinal function were evaluated re-spectively and statistically analyzed. Results Volume of bleeding during surgery,postoperative drainage volume in cer-vical posterior approach group was more than that of cervical anterior approach group,internal fixation cost was higher than that of cervical anterior approach group （P〈0.05）;there was a statistical difference of pre-operative and postopera-tive Frankel grade in two groups before and after surgery （P=0.0015,0.0061） and there was a statistical difference of pre-operative and postoperative JOA score in two groups before and after surgery （P=0.0008,0.0061）. Conclusion The curative effect of cervical anterior approach and posterior approach surgeries in the treatment of cervical spinal cord injury without fracture and dislocation have no significant difference,but surgical injurie,postoperative drainage volume, internal fixation cost in anterior approach group is significantly better than that in posterior approach group respectively.

关 键 词：无骨折脱位 颈髓损伤 手术治疗 

分 类 号：R651.2[医药卫生—外科学]