寰枢椎椎弓根螺钉固定融合疗法与后路寰枢椎经关节螺钉结合寰椎椎板钩固定融合疗法治疗寰枢椎脱位的临床疗效比较  

Comparison of posterior atlantoaxial transarticular screw combined with atlas lamina hook and atlantoaxial pedicle screw fixation and fusion for atlantoaxial dislocation

作　　者：左强 周全 胡靖 胡敏 ZUO Qiang;ZHOU Quan;HU Jing(Department of Spine Surgery,West China Guang'an Hospital(Guang'an People's Hospital),Sichuan University,Guang'an Sichuan 638000,China)

机构地区：[1]四川大学华西广安医院(广安市人民医院)脊柱外科,四川广安638000

出　　处：《临床和实验医学杂志》2022年第6期618-621,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省医学科研青年创新课题计划(编号:Q17036)。

摘　　要：目的比较寰枢椎椎弓根螺钉固定融合疗法与后路寰枢椎经关节螺钉结合寰椎椎板钩固定融合疗法治疗中寰枢椎脱位的临床疗效。方法采用回顾性分析方式,以2018年1月至2021年1月广安市人民医院入院的74例寰枢椎脱位患者为研究对象,根据治疗方法分为对照组(n=37)与实验组(n=37);对照组行寰枢椎椎弓根螺钉固定融合疗法;实验组行后路寰枢椎经关节螺钉结合寰椎椎板钩固定融合疗法。比较两组患者的手术情况(术中出血量、手术时间)、植骨融合率、手术前后颈部僵硬度、颈椎功能障碍指数、生活质量(躯体机能、躯体职能、躯体疼痛、一般健康、活力、社会功能、情感角色限制、心理健康)评分与疼痛评分。结果实验组较对照组术中出血量更低[(207.05±31.54)m L vs.(229.48±33.25)m L],手术时间更短[(123.85±9.22)min vs.(130.94±10.03)min],差异均有统计学意义(P<0.05)。实验组患者的植骨融合率为100.0%,与对照组的97.29%比较,差异无统计学意义(P>0.05)。术前,两组患者的颈部僵硬度、颈椎功能障碍指数、生活质量及疼痛评分比较,差异无统计学意义(P>0.05);术后6个月,两组术后颈部僵硬轻度、重度率与颈椎功能障碍指数、疼痛评分均较术前明显降低,生活质量评分较术前明显增高,差异均有统计学意义(P<0.05);两组患者的颈部僵硬轻度、重度率与颈椎功能障碍指数、生活质量及疼痛评分相比,差异无统计学意义(P>0.05)。结论寰枢椎椎弓根螺钉固定融合疗法与后路寰枢椎经关节螺钉结合寰椎椎板钩固定融合疗法治疗寰枢椎脱位的临床疗效均显著,但后者出血量更低,时间更短。Objective To compare the clinical effects of atlantoaxial pedicle screw fixation and fusion therapy with posterior atlantoaxial transarticular screw combined with atlantoaxial laminar fixation and fusion therapy for central atlantoaxial dislocation.Methods Using retrospective analysis,74 patients with atlantoaxial dislocation admitted to Guang'an People's Hospital from January 2018 to January 2021 were selected as the research objects.According to the treatment method,they were divided into control group(n=37)and experimental group(n=37).The control group underwent atlantoaxial pedicle screw fixation and fusion therapy;the experimental group underwent posterior atlantoaxial pedicle screw fixation and fusion therapy.The operation conditions(intraoperative blood loss,operation time),bone graft fusion rate,neck stiffness before and after the operation,cervical spine dysfunction index,quality of life(physical function,physical function,physical pain,general health,vitality),social function,emotional role restriction,mental health)score and pain score were compared between the two groups of patients.Results Compared with the control group,the intraoperative blood loss in the experimental group was lower[(207.05±31.54)mL vs.(229.48±33.25)mL],and the operation time was shorter[(123.85±9.22)min vs.(130.94±10.03)min],the differences were statistically significant(P<0.05).The bone graft fusion rate in the experimental group was 100.0%,compared with 97.29%in the control group,there was no significant difference(P>0.05).Before operation,there was no significant difference in neck stiffness,cervical spine dysfunction index,quality of life and pain score between the two groups(P>0.05);6 months after operation,the mild and severe rates of neck stiffness,cervical spine dysfunction index and pain score were significantly lower than those before operation in the two groups,and the score of quality of life was significantly higher than that before operation,and the differences were statistically significant(P<0.05);there was no

关 键 词：寰枢椎脱位 后路寰枢椎 关节螺钉 寰椎椎板钩 寰枢椎椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]