摘要
目的比较改良Brooks技术与椎弓根螺钉固定技术治疗寰枢椎不稳的临床疗效。方法手术治疗25例寰枢椎不稳患者,其中改良Brooks技术组(A组)10例,椎弓根螺钉固定技术组(B组)15例。比较两组的手术时间及术中出血量;采用VAS评分比较手术前后疼痛程度,采用ASIA分级系统评价手术前后脊髓功能。结果患者均获得随访,时间12~36个月。手术时间:A组(116.71±7.45)min,B组(139.50±11.89)min,两组比较差异有统计学意义(P<0.01)。术中出血量:A组(281.43±46.70)ml,B组(337.00±45.47)ml,差异有统计学意义(P<0.05)。末次随访VAS评分:两组均较术前明显降低(P<0.01);组间比较差异无统计学意义(P>0.05)。两组末次随访ASIA分级均为E级。结论改良Brooks技术是治疗寰枢椎不稳有效的内固定方法,亦可作为寰椎螺钉置钉失败或局部解剖异常、血管畸形而难以置钉的一种替代固定方式。
Objective To compare effect of modified Brooks technique and the technique of pedicle screw fixation for the treatment of atlanto-axial instability. Methods All 25 patients with atlanto-axial instability underwent surgery, the modified Brooks technology group had l0 cases( group A), atlanto-axial pedicle screw fixation group had 15 cases ( group B). The operation time and bleeding volume of the two groups were compared. VAS system was adopted for therapeutic efficacy evaluation. Spinal cord function before and after operation by ASIA grading system were evalua- ted. Results All patients were followed up for 12 -36 months. The operation time: group A was (116. 71 -+ 7.45 ) min, group B was ( 139.50 -+ 11.89 )min, the difference was statistically significant (P 〈 0. 01 ). The operation bleed- ing volume, group A was(281.43 +46. 70) ml,group B was(337.00 +45.47) ml,the difference was statistically sig- nificant(P 〈0. 05 ). The two groups were significantly lower than preoperative at the last follow-up in VAS (P 〈 0. 01 ). There was no statistically significant difference between the two groups in the last follow-up (P 〉 0, 05). The last follow-up for ASIA grading was grade E. Conclusions Modified Brooks technique can effectively restore the sta- bility of atlanto-axial instability, also can be used as an alternative fixed way which atlas boh nailing failure or local anatomic abnormalities and vascular malformation of nailing.
作者
张志敬
卢一生
潘兵
邹庆
许文根
符楚迪
ZHANG Zhi-fing LU Yi-sheng PAN Bing ZOU Qing XU Wen-geM FU Chu-di(Dept of Orthopaedics, the 117th Hospital of PLA, Hangzhou, Zhe- fiang 310007, China)
出处
《临床骨科杂志》
2017年第5期513-516,共4页
Journal of Clinical Orthopaedics
基金
南京军区医学科技创新面上项目(编号:15MS157)