后路椎弓根螺钉内固定联合前路减压植骨融合治疗颈椎骨折脱位伴关节突交锁的疗效观察  

The clinical observation of posterior pedicle screw fixation combined with anterior decompression and bone graft fusion in the treatment of cervical fracture and dislocation with facet locked

作　　者：薛建喜 方弘伟 黄晓东 高骏 吴俊彪 盛翔 袁登荣 Xue Jianxi

机构地区：[1]浙江省金华市中医医院,321017

出　　处：《浙江临床医学》2021年第1期35-36,39,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：目的探讨后路微创扩张通道下椎弓根螺钉内固定联合前路减压植骨融合治疗颈椎骨折脱位伴关节突交锁患者的疗效。方法选取2016年3月至2019年3月颈椎骨折脱位患者20例,按照手术方式不同分为对照组(8例,前路减压植骨融合术)与观察组(12例,在对照组基础上予后路微创扩张通道下椎弓根螺钉内固定术)。两组患者术后均随访1年,记录并比较两组患者的JOA评分及生活质量。结果术后两组患者JOA评分明显比术前高,且患者JOA评分随治疗时间延长增加,观察组JOA评分明显比对照组高(P<0.05);术后观察组患者健康状况、生理功能、生理职能、情感功能评分均高于对照组(P<0.05)。结论后路微创扩张通道下椎弓根螺钉内固定联合前路减压植骨融合对颈椎骨折脱位伴关节突交锁患者JOA评分及生活质量有明显改善效果,可推广应用。Objective To investigate the effect of posterior minimally invasive dilatation channel pedicle screw fixation combined with anterior decompression and bone graft fusion on JOA score and quality of life in patients with cervical fracture and dislocation with articular process interlocking.Methods Twenty patients with cervical fracture and dislocation treated in our hospital from March 2016 to March 2019 were selected.According to the different surgical methods,the patients were divided into the control group(8 cases,anterior decompression and bone graft fusion),and the observation group(12 cases,the pedicle screw fixation under the minimally invasive dilation channel was performed on the basis of the control group).The patients in both groups were followed up for 1 year.The JOA scores and quality of life were recorded and compared between the two groups.Results The JOA scores of the two groups were significantly higher than those before the operation,and the JOA score increased with the prolongation of treatment time.The JOA score of the observation group was significantly higher than that of the control group(P<0.05).The health status,physiological function,physiological function and emotional function score of the observation group were higher than those of the control group(P<0.05).Conclusion Posterior minimally invasive dilatation channel pedicle screw fixation combined with anterior decompression and bone graft fusion has significant improvement in JOA score and quality of life in patients with cervical fracture and dislocation with articular process interlocking,which can be promoted and applied.

关 键 词：颈椎骨折脱位伴关节突交锁 椎弓根螺钉内固定 前路减压植骨融合 后路微创扩张通道 

分 类 号：R68[医药卫生—骨科学]