前后联合入路手术对颈椎骨折合并脊髓损伤患者近期神经功能影响研究  

Effects of combined anterior and posterior approach on short-term neurological function in patients with cervical spine fracture complicated by spinal cord injury

作　　者：王忻[1] 赵毅[1] 祁学强 常建旗 

机构地区：[1]陕西省延安市人民医院骨科一病区,716000

出　　处：《河北医药》2016年第14期2146-2148,共3页Hebei Medical Journal

摘　　要：目的探讨不同术式对颈椎骨折合并脊髓损伤患者近期神经功能恢复的影响,为临床治疗提供参考依据。方法回顾性分析89例颈椎骨折合并脊髓损伤患者的临床资料,根据不同术式分为单纯前路手术组(前路组,n=28)、单纯后路手术组(后路组,n=23)和前后联合入路手术组(联合组,n=38)。比较3组患者术后椎体复位及神经功能恢复情况。结果术后12个月,3组Cobb角、椎体间滑移距离均低于术前,JOA评分均高于术前,差异有统计学意义(P<0.05);联合组Cobb角、椎体间滑移距离均低于前路组和后路组,JOA评分均高于前路组和后路组,差异有统计学意义(P<0.05);前路组和后路组Cobb角、椎体间滑移距离、JOA评分比较差异无统计学意义(P>0.05)。术后联合组D级+E级比例显著高于前路组和后路组,差异有统计学意义(P<0.05);前路组和后路组D级+E级比例比较差异无统计学意义(P>0.05)。结论与单一入路手术相比,前后联合入路手术明显提高了颈椎骨折合并脊髓损伤患者椎体复位及神经功能恢复效果,且围术期无严重并发症发生,值得临床重视。Objective To investigate the effects of combined anterior and posterior approach on shorter-term neurological function in patients with cervical spine fracture complicated by spinal cord injury in order to provide reference for clinical treatment. Methods The clinical data of 89 patients with cervical spine fracture complicated by spinal cord injury who were admitted and treated in our hospital from May 2014 to January 2009 were retrospectively analyzed. According to different surgical procedure modes,these patients were divided into simple anterior approach group（ anterior approach group,n = 28）,simple posterior approach group（ posterior approach group,n = 23） and combined anterior and posterior approach group（ combination group,n = 38）. The postoperative vertebral reduction and neurological function recovery were observed and compared among the three groups. Results After surgery the proportion of D ＋ E in the combination group was 80. 59%,which was significantly higher than those in anterior approach group and posterior approach group（ 60. 53% and 58. 62%,respectively）（ P 〈0. 05）. However there was no significant difference in the proportion of D ＋ E between anterior approach group and posterior approach group（ P 〈0. 05）. On 12 months after surgery,the Cobb scores in combination group were significantly lower than those in anterior approach group and posterior approach group,however,the JOA scores were significantly higher than those in anterior approach group and posterior approach group（ P 〈0. 05）. Besides there were no significant differences in Cobb angle,I- B slipslip distance,JOA scores between anterior approach group and posterior approach group（ P 〈0. 05）. Conclusion As compared with single approach operation,the combined anterior and posterior approach can significantly improved the recovery of vertebral body and neurological function in patients with cervical spine fracture complicated by spinal cord injury,without severe complications,thus,it is worth bein

关 键 词：颈椎骨折 脊髓损伤 手术入路 神经功能 近期疗效 

分 类 号：R651.21[医药卫生—外科学]