前后路联合手术治疗强直性脊柱炎颈椎骨折的效果与安全性分析  

Analysis of the Effect and Safety of Anterior and Posterior Combined Surgery for the Treatment of Cervical Spine Fractures in Ankylosing Spondylitis

作　　者：曾红生 金健 陈子华 陈鑫营 Zeng Hongsheng(Department of Orthopedics,Second District,People’s Hospital of Heyuan City,Heyuan Guangdong 517000)

机构地区：[1]河源市人民医院骨科二区,广东河源517000 [2]南方医院脊柱骨科,广州白云510515

出　　处：《黑龙江医药》2023年第3期534-538,共5页Heilongjiang Medicine journal

基　　金：河源市科技计划项目(项目编号:190701091503506)。

摘　　要：目的:分析前后路联合手术治疗强直性脊柱炎颈椎骨折的效果与安全性。方法:收集到我院及南方医院接受治疗的强直性脊柱炎颈椎骨折患者临床资料,基于特定时间段内(2019年8月—2020年8月)对其进行选取(30例),均给予前后路联合手术治疗,分析其治疗效果及安全性。结果:对30例患者开展为期15~25个月的随访,平均手术治疗时间(3.63±0.58)小时,平均术中出血量(2010.49±345.02)mL,α角约0°~1.3°,术后脊柱融合、植骨融合良好,无内固定失败出现;26例患者术后脊髓神经功能得到一定程度改善,至少改善1级,4例无明显变化;术后2、4、8、16个月,30例患者疼痛评分及颈椎残障功能评分显著低于术前(P<0.05),骨科神经功能评分显著高于术前(P<0.05);6例患者出现了并发症,并发症发生率为20.00%,经对症干预后好转,无死亡病例。结论:采用前后路联合手术治疗强直性脊柱炎颈椎骨折,可明显提高手术疗效,减轻疼痛,促进脊柱脊髓损伤神经功能恢复,术后虽具有部分患者出现并发症,但经对症干预后好转。Objective:To analyze the effectiveness and safety of anterior and posterior combined surgery for the treatment of cervical spine fractures in ankylosing spondylitis.Method:Clinical data of patients with ankylosing spondylitis and cervical spine fractures treated in our hospital and southern hospitals were collected.Based on a specific time period(August 2019 to August 2020),30 patients were selected and treated with anterior and posterior combined surgery.The treatment effect and safety were analyzed.Result:30 patients were followed up for 15~25months,with an average surgical treatment time of(3.63±0.58)hours and an average intraoperative bleeding volume of(2010.49±345.02)mL,αThe angle is about 0°~1.3°,and the postoperative spinal fusion and bone graft fusion are good,without any internal fixation failure;26 patients had a certain degree of improvement in spinal cord nerve function after surgery,with at least one level of improvement,while 4 patients showed no significant changes;At 2,4,8,and 16 months after surgery,the pain score and cervical disability function score of 30 patients were significantly lower than before surgery(P<0.05),while the orthopedic nerve function score was significantly higher than before surgery(P<0.05);Six patients developed complications,with a complication rate of 20.00%.After targeted intervention,the condition improved and no deaths occurred.Conclusion:The use of a combined anterior and posterior approach for the treatment of cervical spine fractures in ankylosing spondylitis can significantly improve the surgical efficacy,alleviate pain,and promote the recovery of spinal cord injury and neurological function.Although some patients may experience complications after surgery,symptomatic intervention can improve the prognosis.

关 键 词：强直性脊柱炎 颈椎骨折 前后路联合手术 脊椎神经功能 疼痛 并发症 

分 类 号：R683.2[医药卫生—骨科学]