下颈椎骨折脱位合并急性脊髓损伤的手术方式选择及疗效对比

Effect of Different Surgical Approaches on Treatment of Lower Cervical Vertebra Fracture and Dislocation Combined with Acute Spinal Cord Injury

目的:分析不同手术方式处理下颈椎骨折脱位合并急性脊髓损伤疗效。方法:选取2012年10月-2015年10月本院收治的110例下颈椎骨折脱位合并急性脊髓损伤患者作为研究对象。A组36例实施前路手术,B组44例实施后路手术,C组30例实施前后路联合手术。比较三种手术方式的治疗效果。结果:术后12个月,三组患者Cobb角、椎体水平位移距离均较术前显著改善(P<0.05),C组患者改善程度显著高于A、B组(P<0.05);C组患者JOA评分优良率显著高于A、B组(P<0.05);在术后随访过程中,三组患者并发症总发生情况无统计学差异(P>0.05)。结论:前后路联合手术治疗可更好地恢复颈椎解剖结构,促进脊髓神经功能恢复,值得在临床工作中进行推广。

Objective：To analyze the clinical effect of three different surgical approaches on the treatment of lower cervical vertebra fracture and dislocation combined with acute spinal cord injury.Methods：110 patients with lower cervical vertebra fracture and dislocation combined with acute spinal cord injury who were treated in our hospital from October 2012 to October 2015 were selected and randomly divided into three groups.36 patients in group A were treated with anterior surgery,44 patients in group B were treated with posterior surgery,and 30 cases in group C were treated with anterior combined posterior operation.Then the clinical effects of different methods were observed and compared.Results：After operation,the Cobb angle and the horizontal displacement distance of the three groups significantly improved （P〈0.05）.The improvement of group C was significantly higher than that of group A and group B （P 〈0.05）.The JOA score of group C was significantly higher than that of group A and group B （P 〈0.05）.The total incidence of complications had no significant difference among the three groups （P〉0.05）.Conclusion：Anterior and posterior combined surgical treatment jas better effect on the restoring the anatomical structure of cervical spine and promoting the recovery of spinal nerve function,which is worthy of clinical promotion.