后路寰枢椎经关节螺钉结合寰椎椎板钩与寰枢椎椎弓根螺钉固定融合治疗寰枢椎脱位的疗效比较  

Comparison of posterior atlantoaxial transarticular screw fusion combined with atlantoaxial lamina hook and atlantoaxial pedicle screw fixation in the treatment of atlantoaxial dislocation

作　　者：苏李威[1] 杨利[2] 邵林[1] SU Li-wei;YANG Li;SHAO Lin(Department of Orthopedics,The First People's Hospital of Yibin,Yibin Sichuan 644000,China;Department of Health Management Center,The First People's Hospital of Yibin,Yibin Sichuan 644000,China)

机构地区：[1]四川省宜宾市第一人民医院骨科,四川宜宾644000 [2]四川省宜宾市第一人民医院健康管理中心,四川宜宾644000

出　　处：《临床和实验医学杂志》2020年第19期2092-2095,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省教育厅自然科学基金(编号:17ZB0134)。

摘　　要：目的研究后路寰枢椎经关节螺钉结合寰椎椎板钩与寰枢椎椎弓根螺钉固定融合治疗寰枢椎脱位的疗效。方法采用回顾性分析方法,研究对象为2017年6月至2019年6月入院的82例寰枢椎脱位患者,按照不同手术方式分为研究组与对照组,各41例。研究组选用后路寰枢椎经关节螺钉结合寰椎椎板钩固定融合治疗,对照组选用寰枢椎椎弓根螺钉固定融合治疗。比较两组患者手术时间、术中出血量、植骨融合率、术前与术后6个月疼痛视觉模拟量表(VAS)评分、颈椎功能障碍指数、颈部僵硬度。结果研究组手术时间、术中出血量及植骨融合率依次为(124.06±9.31)min、(206.93±31.62)mL、100%,对照组依次为(131.52±10.17)min、(230.71±32.44)mL、97.56%,两组术后植骨融合率无显著差异(P>0.05),研究组较对照组手术时间更短,术中出血量更少(P<0.05)。研究组术前、术后6个月VAS评分分别为(6.87±1.15)分、(1.19±0.48)分,对照组分别为(6.96±1.24)分、(1.26±0.52)分,两组术后较术前VAS评分明显下降(P<0.05),两组术后VAS评分差异无统计学意义(P>0.05)。研究组术前、术后6个月颈椎功能障碍指数评分分别为(37.08±6.33)分、(9.36±2.57),对照组分别为(37.26±6.48)分、(9.52±2.79)分,两组术后较术前颈椎功能障碍指数更低(P<0.05),两组术后颈椎功能障碍指数差异无统计学意义(P>0.05)。研究组术前、术后6个月颈部僵硬轻度分别为68.29%、17.07%,重度率分别为29.27%、0.00%,对照组术前、术后6个月颈部僵硬轻度分别为75.61%、19.51%,重度率分别为24.39%、0.00%。两组术后较术前颈部僵硬度更优(P<0.05),两组术后颈部僵硬度差异无统计学意义(P>0.05)。研究组手术时间、术中出血量及植骨融合率依次为(124.06±9.31)min、(206.93±31.62)mL、100%,对照组依次为(131.52±10.17)min、(230.71±32.44)mL、97.56%,两组术后植骨融合率无显著差异(P>0.05),研究组较对照组手术时Objective To study the efficacy of posterior atlantoaxial transarticular screw fusion combined with atlantoaxial lamina hook and atlantoaxial pedicle screw fixation in the treatment of atlantoaxial dislocation.Methods Retrospective analysis was performed on 82 hospitalized patients with atlantoaxial dislocation from June 2017 to June 2019.In the study group,posterior atlantoaxial transarticular screw fixation combined with atlantoaxial lamina hook fixation was used for fusion therapy,while in the control group,atlantoaxial pedicle screw fixation was used for fusion therapy.The operation time,intraoperative blood loss,and bone graft fusion rate,Visual Analogue Scale/Score(VAS)Score,cervical spine dysfunction index,neck stiffness were compared between the two groups.Results The operation time,intraoperative blood loss and bone graft fusion rate in the study group were(124.06±9.31)min,(206.93±31.62)mL and 100%respectively,while those in the control group were(131.52±10.17)min,(230.71±32.44)mL and 97.56%respectively.There was no significant difference in postoperative bone graft fusion rate between the two groups(P>0.05).shorter The operation time in the study group was shorter and intraoperative blood was less than the control group(P<0.05).VAS scores before and after the operation in the study group were(6.87±1.15)and(1.19±0.48)points,respectively,while those in the control group were(6.96±1.24)and(1.26±0.52)points.Postoperative VAS scores of the two groups were significantly lower than those before surgery(P<0.05).There was no difference in postoperative VAS score between the two groups(P>0.05).The indexes of cervical spine dysfunction before and after surgery in the study group were(37.08±6.33)and(9.36±2.57)points,respectively,while those in the control group were(37.26±6.48)and(9.52±2.79)points.Postoperative cervical spine dysfunction index of the two groups were lower than those before surgery(P<0.05).There was no difference in postoperative cervical spine dysfunction index between the two groups(P>

关 键 词：寰枢椎脱位 后路寰枢椎经关节螺钉 寰椎椎板钩 寰枢椎椎弓根螺钉固定融合 

分 类 号：R687.3[医药卫生—骨科学]