一期前路减压内固定联合后路减压术治疗颈椎外伤后骨折脱位的效果观察  

Observation on the Effect of One-stage Anterior Decompression and Internal Fixation Combined with Posterior Decompression in the Treatment of Fracture and Dislocation after Cervical Trauma

作　　者：杨小勇 武东升 吕曦 张建 孙亮 Yang Xiaoyong;Wu Dongsheng;Lv Xi(Department of the Second Orthopaedics,Weinan Central Hospital,Weinan,Shanxi 714000,China)

机构地区：[1]渭南市中心医院骨二科

出　　处：《四川医学》2019年第11期1158-1161,共4页Sichuan Medical Journal

摘　　要：目的观察一期前路减压内固定联合后路减压术治疗颈椎外伤后骨折脱位的治疗效果。方法选取2013年8月至2018年3月在我院接受治疗的颈椎外伤后骨折脱位患者为研究对象,并根据其治疗方式分为对照组和观察组,对照组给予一期后路扩大减压固定联合前路减压术,观察组给予一期前路减压内固定联合后路减压术。观察两组围手术期一般情况,比较两组患者神经功能恢复、JOA评分、轴性症状发生率的差异。结果两组患者手术时间和手术出血量差异无统计学意义(t=-0.014、-0.009,P=0.495、0.496);两组患者手术前JOA评分无差别,手术后,观察组患者的JOA评分高于对照组,差异有统计学意义(t=-5.885,P<0.001);手术后,观察组患者轴性症状发生率低于对照组,差异有统计学意义(X^2=9.182,P=0.027);两组患者手术前神经功能分级差异无统计学意义(X^2=0.641,P=0.958),手术后,观察组患者D级和E级例数明显较对照组多,差异有统计学意义(X^2=16.087,P=0.003)。结论一期前路减压内固定联合后路减压术对颈椎外伤后骨折脱位有较好的治疗效果,可促进患者神经功能恢复,且术后轴性症状发生率低,具有良好的临床应用价值。Objective To observe the effect of one-stage anterior decompression and internal fixation combined with posterior decompression in the treatment of fracture and dislocation after cervical trauma.Methods Patients with post-traumatic fracture and dislocation of cervical vertebrae who were treated in our hospital from August 2013 to March 2018 were selected as the subjects and divided into control group and observation group according to their treatment methods.The control group was given one stage posterior extended decompression and fixation combined with anterior decompression,while the observation group was given one stage anterior decompression and internal fixation combined with posterior decompression.The general situation of perioperative period between the two groups was observed,and the differences of neurological function recovery,JOA score and incidence of axial symptoms were compared between the two groups.Results There was no significant difference in the operation time and the amount of surgical bleeding between the two groups(t=-0.014、-0.009,P=0.495、0.496).There was no difference in the preoperative JOA score between the two groups.After the operation,the JOA score of the observation group was higher than that of the control group,and the difference was statistically significant(t=-5.885,P<0.001).After surgery,the incidence of axial symptoms in the observation group was lower than that in the control group,and the difference was statistically significant(X^2=9.182,P=0.027).There was no significant difference in preoperative neurological function between the two groups(X^2=0.641,P=0.958).After the operation,the number of D and E cases in the observation group was significantly higher than that in the control group,and the difference was statistically significant(X^2=16.087,P=0.003).Conclusion One-stage anterior decompression and internal fixation combined with posterior decompression has a good therapeutic effect on fracture and dislocation after cervical trauma,which can promote the recovery of n

关 键 词：颈椎 骨折 内固定 减压 JOA 

分 类 号：R683.2[医药卫生—骨科学]