颈椎后路单开门椎管扩大成形术与颈前路减压内固定术治疗颈椎过伸性损伤的疗效

Clinical comparison of posterior cervical single⁃opening spinal canal expansion plasty and anterior cervical decompression internal fixation for cervical hyperextension injury

目的比较颈椎过伸性损伤行颈椎后路单开门椎管扩大成形术与颈前路减压内固定术的疗效。方法选取2018年6月至2021年12月医院骨科收治的57例颈椎过伸性损伤病患,33例行颈椎后路单开门椎管扩大成形术(A组),24例行颈前路减压内固定术(B组)。回顾性分析比较两组的手术及术后恢复指标,论述不同手术入路的疗效及安全性。结果A组手术时间、手术出血量、住院时间较B组更少(P<0.05);A组JOA评分及Frankel分级稍优于B组,融合节段高度与Cobb角稍高于B组,并发症率稍低于B组,但均差异无统计学意义(P>0.05)。结论颈椎过伸性损伤患者根据影像学检查结果,选择后路单开门椎管扩大成形术或前路减压内固定术均能获得较理想疗效,但后路单开门的手术风险更小,减压更彻底,值得优先考虑。

Objective To compare the efficacy of posterior cervical open door enlarged spinal canal plasty with anterior cervical decompression and internal fixation for cervical hyperextension injury.Methods Fifty⁃seven patients with cervical hyperextension injury admitted to the orthopedic department of the hospital from June 2018 to December 2021 were selected,with 33 patients who underwent posterior cervical single⁃opening spinal canal expan⁃sion plasty(group A)and 24 patients who underwent anterior cervical decompression and internal fixation(group B).We retrospectively analyzed and compared the surgical and postoperative recovery indexes of the two groups,while discussing the efficacy and safety of different surgical approaches.Results The operative time,surgical bleeding,and hospital stay were less in group A than in group B(P<0.05);the JOA score and Frankel classification were slightly better in group A than in group B,the fusion segment height and Cobb angle were slightly higher than in group B,and the complication rate was slightly lower than in group B,but none of them were statistically different(P>0.05).Conclusion In patients with cervical hyperextension injury,either posterior single⁃opening spinal canal enlargement plasty or anterior decompression internal fixation can achieve a better outcome according to the imaging findings,but posterior single⁃opening has less surgical risk and more complete decompression,which is worth giving priority to.