无骨折脱位型颈脊髓损伤的手术治疗研究

Study on surgical treatment of cervical spinal cord injury without fracture and dislocation

目的研究评价无骨折脱位型颈脊髓损伤(CSCIWFD)的各手术入路的治疗效果。方法总结纳入2021年1月至2022年7月山东文登整骨烟台医院脊柱脊髓科行手术治疗的74例无骨折脱位型颈脊髓损伤患者进行临床观察性研究,按照不同手术入路方式分为颈椎前路手术A组(33例)、颈椎后路手术B组(29例)和颈椎前后路联合手术C组(12例)。比较三组患者的术后神经功能恢复情况、手术时间、术后并发症。结果颈椎前路手术A组、颈椎后路手术B组和颈椎前后路联合手术C组在术后神经功能恢复上差异无统计学意义(P>0.05)。颈椎前路手术A组并发症及手术时间少于颈椎后路手术B组和颈椎前后路联合手术C组,差异有统计学意义(P<0.05)。结论三组不同手术方式治疗无骨折脱位型颈脊髓损伤的临床效果确切,各手术路径均对患者脊髓神经恢复有促进作用,在手术时间及术后并发症上颈椎前路手术优于颈椎后路手术和颈椎前后路联合手术。

Objective To study and evaluate the therapeutic effects of various surgical approaches for cervical spinal cord injury without fracture and dislocation(CSCIWFD).Methods A clinical observational study was conducted on 74 patients with cervical spinal cord injury without fracture and dislocation who underwent surgical treatment in the Department of Spine and Spinal Cord,Yantai Hospital of Shandong Wendeng Orthopaedics&Trauma Tology from January 2021 to July 2022.According to different surgical approaches,they were divided into anterior cervical surgery group A(33 cases),posterior cervical surgery group B(29 cases),and combined anterior posterior cervical surgery group C(12 cases).The postoperative neurological recovery,surgical time,and postoperative complications among the three groups of patients were compared.Results There was no statistically significant difference in postoperative neurological function recovery between anterior cervical surgery group A,posterior cervical surgery group B,and combined anterior posterior cervical surgery group C(P>0.05).The complications and surgical time in anterior cervical surgery group A were less than those in posterior cervical surgery group B,and combined anterior posterior cervical surgery group C,and the differences were statistically significant(P<0.05).Conclusion The clinical efficacy of three different surgical methods in treating cervical spinal cord injury without fracture and dislocation is definite,and each surgical approach has a promoting effect on the recovery of spinal nerves in patients.In terms of surgical time and postoperative complications,anterior cervical surgery is superior to posterior cervical surgery and combined anterior posterior cervical surgery.