颈后路单开门微型钛板联合单侧侧块钉棒系统内固定治疗无放射影像异常脊髓损伤的疗效与对颈椎矢状面平衡变化的影响  

Effect of cervical posterior single open-door micro titanium plate combined with lateral mass screw-rod internal fixation in treatment of spinal cord injury without radiographic abnormality and its influence on changes of cervical sagittal balance

作　　者：邹玉彬 路磊 吴冰 何勇 谢建新 朱大安 ZOU Yu-bin;LU Lei;WU Bing;HE Yong;XIE Jian-xin;ZHU Da-an(Department of Orthopaedics,General Hospital of Shaoxing Central Hospital,Shaoxing,Zhejiang 312030,China)

机构地区：[1]绍兴市中心医院骨科,浙江312030

出　　处：《中国骨与关节损伤杂志》2022年第9期897-901,共5页Chinese Journal of Bone and Joint Injury

基　　金：绍兴市科技计划项目(2020001025)。

摘　　要：目的比较颈后路单开门微型钛板联合单侧侧块钉棒系统内固定与单纯颈后路单开门微型钛板内固定治疗无放射影像异常脊髓损伤的临床疗效。方法回顾性分析自2015-06—2020-06诊治的42例无放射影像异常脊髓损伤,17例采用颈后路单开门微型钛板联合单侧侧块钉棒系统内固定治疗(联合组),25例单纯采用颈后路单开门微型钛板内固定治疗(微型钛板组)。比较两组手术时间、术中出血量、住院时间、并发症发生率,比较两组术前、术后12个月疼痛VAS评分、JOA评分、NDI评分、C_(2~7)矢状面轴向距离(Sagittal vertical axis,SVA)、C_(2~7)Cobb角、T_(1)倾斜角(Slope)。结果两组均顺利完成手术并获得至少12个月的随访。两组手术时间、术中出血量、住院时间、并发症发生率比较差异无统计学意义(P>0.05)。两组术前、术后12个月疼痛VAS评分、JOA评分、NDI评分比较差异无统计学意义(P>0.05)。两组术前C_(2~7)SVA、C_(2~7)Cobb角、T_(1)Slope比较差异无统计学意义(P>0.05);术后12个月联合组C_(2~7)SVA较微型钛板组小,C_(2~7)Cobb角较微型钛板组大,差异有统计学意义(P<0.05),两组T_(1)Slope比较差异无统计学意义(P>0.05)。结论颈后路单开门微型钛板联合单侧侧块钉棒系统内固定具有良好的保持术后颈椎矢状位面平衡效果,能维持颈椎稳定性。ObjectiveTo compare the clinical efficacy of cervical posterior single open-door micro titanium plate combined with lateral mass screw-rod internal fixation and cervical posterior single open-door micro titanium plate internal fixation in the treatment of cervical spinal cord injury without radiographic abnormality.MethodsFrom June 2015 to June 2020,42 patients with spinal cord injury without abnormal radiographic images were retrospectively analyzed,17 patients were treated with posterior cervical single-door micro titanium plate combined with unilateral lateral mass screw rod system internal fixation(combination group),25 patients were treated with single-door micro titanium plate internal fixation by the posterior cervical approach(micro titanium plate group).The operation time,intraoperative bleeding volume,hospital stay and the incidence of complications were compared between the two groups.The pain VAS score,JOA score,NDI score,C_(2~7)SVA,C_(2~7)Cobb angle and T_(1)slope before and 12 months after operation were compared between the two groups.ResultsThe surgical treatrnent was successfully completed in two groups and they were followed up for at least 12 months.There was no significant difference in operation time,intraoperative bleeding volume,hospital stay and the incidence of complications between the two groups(P>0.05).There was no significant difference in VAS score,JOA score and NDI score between the two groups before and 12 months after operation(P>0.05).There was no significant difference in C_(2~7)SVA,C_(2~7)Cobb angle and T_(1)slope between the two groups before operation(P>0.05).The C_(2~7)SVA in the combined group was smaller than that in the micro titanium plate group and the C_(2~7)Cobb angle in the combined group was larger than that in the micro titanium plate group at 12 months after operation,the difference was statistically significant(P<0.05),but there was no statistically significant difference in T_(1)slope between the two groups(P>0.05).ConclusionCervical posterior single open-door m

关 键 词：无放射影像异常脊髓损伤 颈后路单开门微型钛板内固定 钉棒系统内固定 颈椎矢状面平衡 

分 类 号：R687.3[医药卫生—骨科学]