微创通道椎弓根螺钉内固定术对颈椎骨折脱位患者的影响  

作　　者：薛建喜 方弘伟 朱元[2] 黄晓东 高骏 

机构地区：[1]浙江省金华市中医医院,321017 [2]杭州市萧山第一人民医院,311200

出　　处：《浙江临床医学》2020年第12期1766-1768,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省金华市科技计划项目(2018-3-023)。

摘　　要：目的探究筋骨并重理论指导下微创通道椎弓根螺钉内固定术对颈椎骨折脱位患者术中出血量、颈痛量表(NPQ)评分及术后颈椎节段屈伸活动度(ROM)的影响。方法选取2016年1月至2019年3月收治的颈椎骨折脱位患者56例,根据入院顺序分为观察组与对照组,对照组采用微创通道椎弓根螺钉内固定术治疗,观察组采用筋骨并重理论指导下的微创通道椎弓根螺钉内固定术治疗,对比两组患者临床疗效、术中出血量、手术切口长度、血清肌酸激酶(CK)、NPQ评分及术后ROM。结果观察组治疗总有效率92.86%显著高于对照组71.43%,差异有统计学意义(P<0.05);观察组术中出血量与手术切口均明显少于对照组,差异有统计学意义(P<0.05);术后1d、3d及7d,观察组血清CK水平均明显低于对照组,差异有统计学意义(P<0.05);术后3个月,观察组NPQ评分明显低于对照组,ROM值显著高于对照组,差异均有统计学意义(P<0.05)。结论筋骨并重理论指导下微创通道椎弓根螺钉内固定术治疗颈椎骨折脱位效果良好,手术创伤轻,术中出血量少,且能够有效减轻颈痛,提高颈椎节段屈伸活动度。Objective To explore the efects of minimally invasive pedicle screw fixation with the guidance of the theory of emphasis on both sinews and bones on intraoperative bleeding volume,Northwick Park Questionnaire(NPQ)score and postoperative range of motion of cervical segment(ROM)in patients with cervical spondylotic myelopathy(CSM).Methods 56 patients with cervical spine fracture and dislocation from January 2016 to March 2019 were divided into observation group and control group according to the order of admission.The control group was treated with minimally invasive pedicle screw fixation,while the observation group was treated with minimally invasive pedicle screw fixation under the guidance of the theory of emphasis on both sinews and bones.The clinical efficacy,intraoperative bleeding volume,incision length,serum creatine kinase(CK)level,NPQ score and ROM were compared between the two groups.Results The total effective rate of the observation group was 92.86%,which was significantly higher than 71.43%of the control group,and the difference was significant(P<0.05).The bleeding volume and incision in the observation group were signifcantly less than those in the control group,and the differences were significant(P<0.05).On the Ist,3rd and 7th day after operation,the serum CK level in the observation group was significantly lower than that in the control group,and the difference was significant(P<0.05).3rd months after operation,the NPQ score of the observation group was significantly lower than that of the control group,and the ROM value was significantly higher than that of the control group,with statistical significances(P<0.05).Conclusion Minimally invasive pedicle screw fixation with the guidance of the theory of emphasis on both sinews and bones is effective in the treatment of cervical spondylotic myelopathy,with less trauma,less intraoperative bleeding volume,and can effectively reduce cervical pain and improve postoperative range of motion of cervical segment.

关 键 词：筋骨并重理论 微创通道椎弓根螺钉内固定术 颈椎骨折脱位 颈椎节段屈伸活动度 

分 类 号：R68[医药卫生—骨科学]