颈前路螺钉与后路椎弓根钉固定Ⅱ型齿状突骨折疗效对比

Comparison Analysis of Clinical Effect of Anterior Internal Fixation with Hollow Screw and Posterior Internal Fixation with Pedicle Screw on the Odontoid Process Fracture

目的对比分析前路空心钉和后路椎弓根钉内固定治疗Ⅱ型齿状突骨折的临床疗效。方法自2004年3月至2008年12月筛选40例Ⅱ型齿状突骨折患者,均接受手术治疗,其中14例采用空心钉前路固定,26例采用后路椎弓根钉内固定。所有患者平均随访24.2个月。记录手术时间、术中出血量、术中透视次数,随访摄片检查齿状突愈合情况,并根据JOA评分进行对比评分。结果两组术中出血量、术中透视次数有统计学意义(P<0.05),而平均手术时间、平均愈合时间、JOA评分则无统计学意义(P>0.05)。结论两种手术内固定方法治疗Ⅱ型齿状突骨折均有明显疗效,前路空心钉组创伤小、出血少、愈合快,但术中接受X线照射次数多,适应证窄。

Objective To review clinical outcome of odontoid process fracture treated with hollow screw and pedicle screw.Methods 40 cases with odontoid process fracture were treated with operation,of which carried out with hollow screw in 14 while using pedicle screw in other 26.Results All patients were followed up for a mean 24.2 months.Operation duration,blood loss and perspective during operation and function of JOA were compared.Conclusion Curative effect was achieved in all two groups.Odontoid process fracture treated with hollow screw is less trauma and blood loss.However,it has more radiation and less indication.