颈椎后路单开门结合椎弓根钉内固定治疗长节段颈脊髓损伤的临床疗效

Clinical Efficacy Traumatic Cervical Spinal Cord Injury with Posterior Cervical Single Door and Pedicle Screw Internal Fixation

目的:探究颈椎后路单开门结合椎弓根钉内固定治疗外伤性长节段颈脊髓损伤的临床治疗效果。方法:回顾性的选取2012年6月至2016年6月我院收治的86例外伤性长节段颈脊髓损伤患者为本次研究对象,根据患者所采用的治疗方法分为观察组(42例)和对照组(44例)。观察组患者采用颈椎后路单开门结合椎弓根钉内固定治疗,对照组患者采用甲强龙冲击疗法。两组患者在完成治疗后进行12个月至36个月随访,比较两组患者临床疗效、颈椎日本骨科协会评估治疗分数(JOA)及并发症发生情况。结果:观察组患者临床疗效优良率显著高于对照组,其差异有统计学意义(P<0.05)。治疗前两组患者JOA评分比较差异无统计学意义(P>0.05),治疗随访12个月时两组患者JOA评分均有显著提高,其差异有统计学意义(P<0.05);治疗随访12个月时观察组患者JOA评分显著高于对照组,其差异有统计学意义(P<0.05)。观察组患者总并发症发生率显著低于对照组,其差异有统计学意义(P<0.05)。结论:颈椎后路单开门结合椎弓根钉内固定治疗外伤性长节段颈脊髓损伤具有良好临床疗效,可有效改善患者颈髓功能,降低并发症发生率,有效提高患者生活质量。

Objective:To explore the clinical effect of single open-door Expansive Laminoplasty combined with pedicle screw fixation in the treatment of traumatic long cervical spinal cord injury.Methods:From June 2012 to June 2017,86 patients with traumatic long cervical spinal cord injury were selected and divided into observation group(n=42)and control group(n=44).The patients in the observation group were treated with single open-door Expansive Laminoplasty combined with pedicle screw fixation,while the patients in the control group were treated with nail shock therapy.The patients in the two groups were followed up for 12~36 months after the treatment.The clinical efficacy of the two groups was compared.To compare the clinical efficacy the Japanese Orthopaedic Association Scores(JOA)and the incidence of complications of the two groups.Results:The excellent and good rate of clinical effect in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in JOA scores between the two groups before treatment(P>0.05).The JOA scores of the two groups were significantly improved after 12 months of follow-up,and the difference was statistically significant(P<0.05).The JOA score in the observation group was significantly higher than that in the control group after 12 months follow-up(P<0.05).The incidence of total complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The treatment of traumatic long cervical spinal cord injury with single open-door expansive laminoplasty combined with pedicle screw fixation has a good clinical effect.It can effectively improve the cervical spinal cord function,reduce the incidence of complications and improve the quality of life of the patients.