单纯前路手术及椎体前内固定治疗颈椎骨折脱位伴多节段颈髓损伤的临床疗效

Clinical effect of simple anterior approach and anterior internal fixation in the treatment of cervical spine fracture dislocation complicated with multiple cervical spinal cord injury

目的探究单纯前路手术及椎体前内固定治疗颈椎骨折脱位伴多节段颈髓损伤的临床疗效。方法选择我院颈椎骨折脱位伴多节段颈髓损伤的患者78例,随机分为试验组与对照组,各39例。试验组患者行单纯前路椎间盘及部分切除、牵开复位、椎间植骨融合钛板椎体前内固定,对照组患者行颅骨牵引复位、颈后路侧块螺钉内固定术。观察两组患者脊髓的损伤程度(ASIA)及颈椎JOA评分。结果术后,试验组患者的ASIA分级D、E级占比均略高于对照组(P>0.05);治疗后,两组患者的JOA评分明显优于治疗前,且试验组优于对照组(P<0.05)。结论单纯前路手术及椎体前内固定治疗颈椎骨折脱位伴多节段颈髓损伤效果确切,有助于术后恢复。

Objective To investigate the clinical effects of simple anterior approach and anterior internal fixation in the treatment of cervical spine fracture dislocation complicated with multiple cervical spinal cord injury. Methods Seventy-eight patients with cervical spine fracture dislocation complicated with multiple cervical spinal cord injury in our hospital were selected and randomly divided into experimental group and control group, with 39 cases in each group. The experimental group was treated with simple anterior discectomy and partial resection, distraction reduction, interbody fusion and peptide plate anterior fixation. The control group received traction reduction of skull and posterior cervical lateral mass screw fixation. The degree of spinal cord injury(ASIA) and cervical spine JOA scores were observed in the two groups.Results The proportions of grade D and E of postoperative ASIS grade in the experimental group were slightly higher than those in the control group(P>0.05). After treatment, the JOA scores of the two groups were than before treatment, and those of the qexperimental group was better than the control group(P <0.05). Conclusion The simple anterior approach and anterior internal fixation in the treatment of cervical spine fracture dislocation complicated with multiple cervical spinal cord injuries has accurate effect, and it is helpful for the recovery of neurological function after operation.