后路微创经皮椎弓根钉内固定术治疗下颈椎骨折脱位的效果观察

Minimally invasive cervical pedicle screw fixation by a posterior approach for lower cervical fracture and dislocation

目的观察后路微创经皮椎弓根钉内固定术对下颈椎骨折脱位的疗效。方法56例下颈椎骨折脱位患者分别采用后路经皮微创椎弓根钉内固定(研究组,37例)或常规椎弓根螺钉置入(对照组,19例)治疗,比较两组术中出血量、手术时间、住院时间、螺钉误置率、并发症、颈椎JOA评分等。结果研究组术中出血量、手术时间、住院时间、螺钉误置率少于对照组(P<0.01),而JOA评分高于对照组(P<0.05)。术后两组均未出现严重伤口感染、神经根损伤、椎弓根钉拔出、断裂等并发症。结论后路皮微创椎弓根钉内固定治疗下颈椎骨折脱位具有创口小、出血少、疗效好等优点。

Objective To observe the clinical efficacy of minimally invasive cervical pedicle screw fixation(MICPSF)by a posterior approach for lower cervical fracture and dislocation(LCFD).Methods Fifty-six patients with LCFD underwent MICPSF(observation group,n=37)or conventional pedicle screw insertion(control group,n=19)by a posterior approach.Intraoperative bleeding,operative and hospitalization time,pedicle screw misplacement,complications,and Japanese Orthopedic Association(JOA)scores were compared between two groups.Results Compared with control group,intraoperative bleeding,operative and hospitalization time,and pedicle screw misplacement were lower(P<0.01),while JOA scores were higher(P<0.05)in observation group.Severe wound infection,nerve root injury,and pedicle screw extrusion or rupture were absent in both groups.Conclusion MICPSF by a posterior approach is effective for LCFD with small wound and less bleeding.