HBO联合颈椎后路椎管扩大成形术治疗老年颈椎过伸性脊髓损伤的疗效观察  

Efficacy of HBO Combined with Posterior Cervical Spinal Canal Expansion in the Treatment of Senile Cervical Hyperextension Spinal Cord Injury

作　　者：李伟 刘波 周宏明 LI Wei;LIU Bo;ZHOU Hongming(Department of spine surgery,Linyi central hospital,Linyi,Shandong 276400)

机构地区：[1]临沂市中心医院骨科,山东临沂276400

出　　处：《中国伤残医学》2023年第13期1-4,9,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：临沂市科技创新发展计划。

摘　　要：观察HBO联合颈椎后路椎管扩大成形术治疗老年颈椎过伸性脊髓损伤的疗效。方法:采用前瞻性对照研究,选取我院脊柱外科2019年1月—2021年1月收治的老年颈椎过伸性脊髓损伤患者61例为研究对象,按照随机数字表法,随机分为观察组31例,对照组30例,对照组患者行颈椎后路椎管扩大成形术,观察组患者行颈椎后路椎管扩大成形术+HBO治疗,2组患者均随访3个月,比较2组患者术前及末次随访时颈部疼痛视觉评分(Visual analogue scale,VAS评分)、日本改良JOA评分(Japanese Orthopadic Association,JOA)和ASIA神经功能分级评分(American Spinal Injury Association,ASIA),同时观察2组患者术后第1天、HBO治疗后第3天及末次随访时外周血IL-6和TNF-α变化。结果:与本组治疗前比较,2组患者VAS评分、JOA评分、ASIA评分均明显改善,差异有统计学意义(P<0.01),且观察组治疗后明显优于对照组,差异有统计学意义(P<0.05);与本组治疗前比较,2组患者血清IL-6、TNF-α水平均降低,差异有统计学意义(P<0.01),且观察组治疗后明显低于对照组,差异有统计学意义(P<0.05)。结论:HBO联合颈椎后路椎管扩大成形术可降低脊髓损伤的炎症反应,促进神经功能恢复,提高患者生存质量,临床效果确切。Objective:To observe the effect of HBO combined with posterior cervical spinal canal expansion in the treatment of elderly cervical spinal hyperextension spinal cord injury.Methods:A prospective controlled study was used to select 61 elderly patients with cervical hyperextension spinal cord injury who were admitted to our hospital from January 2019 to January 2021 as the research objects.They were randomly divided into experimental and control groups.The control group received cervical spine surgery.Posterior spinal canal enlargement surgery.Patients in the experimental group underwent posterior cervical spinal canal augmentation+HBO treatment.Both groups were followed up for three months.The visual scores of neck pain(Visual analogue scale,VAS score),Japanese modified JOA score(Japanese Orthopadic Association,JOA)and ASIA neurological function classification score(American Spinal Injury Association,ASIA),and observe the two groups of patients on the first day after surgery and the third day after HBO treatment And changes in peripheral blood IL-6 and TNF-αat the last follow-up.Results:Compared with this group before treatment,the VAS score,JOA score,and ASIA score of the two groups were significantly improved,and the difference was statistically significant(P<0.01),and the experimental group was significantly better than the control group after treatment,and the difference was statistically significant(P<0.05).Compared with this group before treatment,the serum IL-6 and TNF-αlevels of the two groups of patients decreased,the difference was statistically significant(P<0.01),and the experimental group was significantly lower than the control group after treatment,the difference was statistically significant(P<0.05).Conclusion:HBO combined with posterior cervical spinal canal enlargement can reduce the inflammatory response of spinal cord injury,promote the recovery of extension function,and improve the quality of life of patients,with definite clinical results.

关 键 词：高压氧 脊髓损伤 炎症反应 颈椎管扩大成形术 IL-6 TNF-Α 

分 类 号：R681.5[医药卫生—骨科学]