颈前路减压植骨融合内固定术对无骨折脱位型颈脊髓损伤患者预后的影响

Effect of Anterior Cervical Decompression and Bone Fusion Internal Fixation on the Prognosis of Patients with No Fracture and Dislocation of Cervical Spinal Cord Injury

目的:探讨颈前路减压植骨融合内固定术对无骨折脱位型颈脊髓损伤患者预后的影响。方法:选择2019年2月-2021年2月于三明市第二医院治疗的无骨折脱位型颈脊髓损伤的患者90例,随机分为参照组(采用保守治疗,45例)与研究组(采用颈前路减压植骨融合内固定术治疗,45例)。观察和比较两组治疗前后的颈神经功能、颈脊髓功能[日本骨科协会(JOA)颈椎功能评分]、颈椎功能障碍指数(NDI)改善情况。结果:治疗前,两组颈神经功能评分比较差异无统计学意义(P>0.05);治疗后,两组颈神经功能评分均高于治疗前,且研究组颈神经功能评分(4.49±0.31)分,高于参照组的(3.78±0.38)分(P<0.05)。治疗前,两组JOA评分比较差异无统计学意义(P>0.05);治疗后,两组JOA评分均高于治疗前,且研究组JOA评分(15.82±1.15)分,高于参照组的(13.79±1.32)分(P<0.05)。治疗前,两组NDI评分比较差异无统计学意义(P>0.05);治疗后,两组NDI评分均低于治疗前,且研究组NDI评分(17.47±2.25)分,低于参照组的(24.21±3.13)分(P<0.05)。结论:采用颈前路减压植骨融合内固定术治疗无骨折脱位型颈脊髓损伤,有利于改善患者颈神经功能,减轻颈椎功能障碍,促进脊髓功能恢复。

Objective:To explore the effect of anterior cervical decompression and internal fixation on patients with no fracture and dislocation cervical spinal cord injury.Method:A total of 90 patients with no fracture and dislocation cervical spinal cord injury treated in Sanming Second Hospital from February 2019 to February 2021,randomized into reference group (conservative treatment,45 cases) and study group (with anterior decompression and bone fusion internal fixation,45 cases).Observed and compared the improvement of cervical nerve function,cervical spinal cord function[Japan Orthopaedic Association (JOA) cervical spine function score],and cervical dysfunction index (NDI) before and after treatment in the two groups.Result:Before treatment,there was no significant difference in the cervical nerve function scores of the two groups (P>0.05);after treatment,the cervical nerve function scores of the two groups were higher than before treatment,and the cervical nerve function score (4.49±0.31) of the study group was higher than that of the reference group (3.78±0.38) points (P<0.05).Before treatment,there was no significant difference in the JOA scores of the two groups (P>0.05);after treatment,the JOA scores of the two groups were higher than before treatment,and the JOA score of the study group was (15.82±1.15) points,which was higher than (13.79±1.32) points of the reference group (P<0.05).Before treatment,there was no significant difference in the NDI scores of the two groups (P>0.05);after treatment,the NDI scores of the two groups were lower than those before treatment,and the NDI score of the study group was (17.47±2.25) points,which was lower than (24.21±3.13) points of the reference group (P<0.05).Conclusion:The treatment of no fracture and dislocation of cervical spinal cord injury with anterior cervical decompression and bone fusion is conducive to improving the patients’ cervical nerve function,reducing cervical dysfunction,and promoting the recovery of spinal cord function.