寰枢侧块固定时保留颈2神经根对复位程度及神经功能的影响研究

The effect of retention of C_2 never root during atlantoaxial fixation on reposition degree and nerve function

目的研究寰枢侧块关节内固定手术时保留颈2神经根对复位程度及神经功能的影响。方法 2013年8月至2014年9月,我科对收治的合并寰枕融合的寰枢椎脱位患者71例行寰枢侧块关节复位、钉棒内固定术,其中颈2神经根保留组39例,颈2神经根切断组32例,比较两组复位程度及临床症状改善情况,并问卷调查评估后枕部疼痛与麻木的严重程度及对生活质量的影响。结果颈2神经根保留组与切断组复位程度及后枕部皮肤疼痛/麻木差异均无统计学意义(P>0.05)。结论寰枢侧块关节内固定手术时保留颈2神经根对手术复位程度无太大影响,导致的后枕部疼痛或麻木不影响患者术后日常生活。

Obej ctive To determine the effect of retention of C 2 nerve root during atlantoaxial fixation on reposition degree and nerve function.Metho ds From August ,2013 to September,2014,71 patients underwent atlantoaxial fixation in our department .Of the 71 patients,C2 nerve root was preserved in39 cases and cut in 32 cases.A 3D-CT was used to assess the reposition degree and a ques-tionnaire was used to determine the severity of occipital numbness or pain and its effect on quality of life .Results There was no statis-tically significant difference in reposition degree and occipital neuralgia /numbness .Conclusion The preservation of C 2 nerve root does not affect the reposition degree .Sacrifice of the C2 nerve root is associated with increased occipital numbness while preservation of the C2 nerve root is associated with occipital neuralgia .However,both of methods have no effect on patients ＇quality of life.