两种入路手术治疗强直性脊柱炎合并下颈椎骨折脱位的疗效比较  

Efficacy comparison of two kinds of approaches for treatment of ankylosing spondylitis complicated with fracture and dislocation of lower cervical vertebrae

作　　者：梁树威[1] 林树体[1] 黄家良[1] 杨叶锋[1] LIANG Shu-wei;LIN Shu-ti;HUANG Jia-liang;YANG Ye-feng(Dept of Orthopaedics,the First People′s Hospital of Qinzhou City,Qinzhou,Guangxi 535000,China)

机构地区：[1]钦州市第一人民医院骨科,广西钦州535000

出　　处：《临床骨科杂志》2022年第3期310-313,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较前路与前后联合入路手术治疗强直性脊柱炎合并下颈椎骨折脱位的疗效。方法将19例强直性脊柱炎合并下颈椎骨折脱位患者根据手术入路不同分为前后联合入路组(采用前后联合入路内固定融合术治疗,9例)和前路组(采用前路内固定融合术治疗,10例)。记录骨折愈合情况、术后并发症发生情况,比较两组末次随访时神经功能恢复情况。结果患者均获得14个月随访。两组术后均戴硬质颈托3个月。骨折愈合时间:前后联合入路组2~5(3.6±0.5)个月,前路组2~5(3.4±0.3)个月,差异无统计学意义(P>0.05)。Frankel分级:两组末次随访时均优于术前(P<0.05),末次随访时前后联合入路组优于前路组(P<0.05)。术后并发症发生率前后联合入路组低于前路组(P<0.05)。结论相较于前路手术,前后联合入路手术治疗强直性脊柱炎合并下颈椎骨折脱位术后并发症更少,神经功能恢复更好。Objective To compare the efficacy of anterior and anterior-posterior combined approaches in the treatment of ankylosing spondylitis(AS)with fracture and dislocation of the lower cervical vertebrae.Methods The 19 patients who suffered from AS complicated with fracture and dislocation of cervical vertebrae were divided into two groups according to different surgical approaches:anterior-posterior combined approaches group(9 cases were performed with anterior-posterior combined approaches internal fixation fusion)and anterior approach(10 cases were adopted with anterior approach internal fixation fusion).Fracture healing and postoperative complications were recorded,and the neurological recovery of the two groups was compared at the last follow-up.Results All patients were followed up for 14months.Both groups patients needed to wear rigid neck brace for 3 months after operation.Fracture healing time:2~5(3.6±0.5)months in the anterior-posterior combined approaches group and 2~5(3.4±0.3)months in the anterior approach group,there was no statistical significance(P>0.05).Frankel classification:at the last follow-up,both groups were better than before operation(P<0.05),and the anterior-posterior combined approaches group was better than the anterior approach group at the final follow-up(P<0.05).The incidence rate of postoperative complications in anterior-posterior combined approaches group was lower than that in anterior approach group(P<0.05).Conclusions Compared with anterior approach,anterior-posterior combined approaches are used to treat AS combined with fracture and dislocation of the lower cervical vertebrae,which have fewer postoperative complications and better neurological function recovery.

关 键 词：强直性脊柱炎 下颈椎骨折脱位 前后联合入路 前路内固定融合术 

分 类 号：R681.51[医药卫生—骨科学] R683.2[医药卫生—外科学] R687.3[医药卫生—临床医学]