颈椎前路与后路减压复位融合术治疗下颈椎骨折伴脊髓损伤的对照研究

doi:10.3969/j.issn.1671-7171.2021.09.009

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摘要【目的】比较颈椎前路与颈椎后路减压复位融合术治疗下颈椎骨折伴脊髓损伤的临床疗效。【方法】选取2013年10月至2018年10月于本院收治的62例下颈椎骨折伴脊髓损伤的患者为研究对象,按随机数字表法分为对照组和观察组,其中对照组行后路减压复位融合内固定术治疗,观察组行前路减压复位融合内固定术治疗。术后对两组患者均进行为期1年的随访,观察两组患者手术时间、术中出血量、创口直径、住院时间、椎体复位情况、神经功能恢复等情况,并记录两组患者随访期间并发症发生率。【结果】术后两组患者均获得为期1年的随访,无失访者。观察组手术时间、术中出血量、创口直径、住院时间均少于对照组(P<0.05);末次随访时两组患者平均Cobb角及椎体间滑移距离均降低,JOA评分提高,且与对照组相比,观察组平均Cobb角及椎体间滑移距离降低、JOA评分提高更显著(P<0.05);随访期间观察组并发症总发生率低于对照组(P<0.05)。【结论】采用前路减压复位融合内固定术治疗下颈椎骨折伴脊髓损伤可有效提高临床效果,有利于促进颈椎解剖结构恢复。

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	赵龙珍
	边燕

关键词 ：颈椎/外科学, 脊髓损伤, 脊柱融合术, 减压术,外科/方法

Abstract：【Objective】To compare the clinical effects of anterior and posterior cervical decompression, reduction and fusion in the treatment of lower cervical fracture with spinal cord injury. 【Methods】 A total of 62 patients with lower cervical fracture with spinal cord injury treated in our hospital from October 2013 to October 2018 was randomly divided into control group and observation group. The control group was treated with posterior decompression, reduction, fusion and internal fixation, and the observation group was treated with anterior decompression, reduction, fusion and internal fixation. The patients in both groups were followed up for one year. The operation time, intraoperative bleeding, wound diameter, hospital stay, vertebral reduction and neurological recovery were observed, and the incidence of complications during the follow-up were recorded. 【Results】 The patients in both groups were followed up for 1 year, and there was no loss of follow-up. The operation time, intraoperative bleeding, wound diameter and hospital stay in the observation group were less than those in the control group (P<0.05); At the last follow-up, the average Cobb angle and inter vertebral slip distance decreased and JOA score increased in the two groups. Compared with the control group, the average Cobb angle and inter vertebral slip distance decreased and JOA score increased more significantly in the observation group (P<0.05); The total incidence of complications in the observation group was lower than that in the control group (P<0.05). 【Conclusion】Anterior decompression, reduction, fusion and internal fixation in the treatment of lower cervical fracture with spinal cord injury can effectively improve the clinical effect and promote the recovery of cervical anatomical structure.

Key words： Spinal Fractures/SU Spinal Cord Injuries Spinal Fusion Decompression, Surgical/MT

收稿日期: 2021-05-24

中图分类号:

R687.3

引用本文:

赵龙珍, 边燕. 颈椎前路与后路减压复位融合术治疗下颈椎骨折伴脊髓损伤的对照研究[J]. 医学临床研究, 2021, 38(9): 1311-1314.
ZHAO Long-zhen, BIAN Yan. Comparative Study of Anterior and Posterior Decompression, Reduction and Fusion in the Treatment of Lower Cervical Fracture with Spinal Cord Injury. JOURNAL OF CLINICAL RESEARCH, 2021, 38(9): 1311-1314.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.09.009 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I9/1311

[1] 徐艳松, 罗大卿, 潘文辉,等. 创伤性颈脊髓损伤的流行病学分析[J].中华急诊医学杂志, 2019, 28(1):84-89.
[2] 李东方, 周英杰, 史相钦,等. 平乐正骨手法在下颈椎骨折脱位复位中的作用[J].中华中医药杂志, 2018, 33(2):792-794.
[3] 舒莉, 吴萍, 胡永胜,等. 前路与后路手术治疗胸腰段椎体爆裂骨折的比较[J].中国矫形外科杂志,2019,24(10):901-906.
[4] 范红松, 刘连, 敖俊, 等. 后路经肌间隙入路与开放入路内固定治疗胸腰椎骨折脱位的疗效比较[J].中华创伤杂志, 2018,33(2):121-129.
[5] 程建, 刘明明, 郭杨,等. 针药结合联合手术治疗胸腰椎骨折伴脊髓损伤的临床疗效观察[J].中华中医药杂志, 2019, 34(3):1274-1277.
[6] 梁卫东, 任周梁, 盛军, 等. 合并脊髓损伤的难治性儿童齿状突骨折合并寰枢椎脱位的手术疗效分析[J].中华医学杂志, 2018,33(8):587-591.
[7] SAKITANI N, IWASAWA H, NOMURA M, et al. Mechanical stress by spasticity accelerates fracture healing after spinal cord injury[J].Calcif Tissue Int,2017,101(4):384-395.
[8] 崔学锋, 梁文杰. 磁共振弥散张量成像在无骨折脱位型脊髓损伤早期诊断中的价值[J].中国矫形外科杂志, 2019, 27(12):1144-1146.
[9] 张华, 梅伟, 王祥善,等. 脊柱骨折合并脊髓损伤患者血清转化生长因子β1的变化及其临床意义[J].中华实验外科杂志, 2017, 34(11):1857-1860.
[10] CREMOUX S, TALLET J, DAL MASO F, et al. Impaired corticomuscular coherence during isometric elbow flexion contractions in human with cervical spinal cord injury[J].Eur J Neurosci,2017,46(4):1991-2000.
[11] 王建杰, 徐委, 任亦龙,等. 前路减压与稳定性重建对颈椎过伸性损伤的临床疗效[J].中华医学杂志, 2018, 98(47):3858-3863.
[12] 袁杨, 雷飞, 周春光,等. 经颈前咽后入路前路松解二期后路复位融合内固定术治疗难复性寰枢关节脱位[J].中国修复重建外科杂志, 2018, 32(11):18-22.
[13] FRANCISCO G E, YOZBATIRAN N, BERLINER J, et al. Robotassisted training of arm and hand movement shows functional improvements for incomplete cervical spinal cord injury[J].Am J Phys Med Rehabil,2017, 96(10):171-177.
[14] 朱旻宇, 滕红林, 黄克伦, 等. 后路经皮内窥镜下颈椎间盘切除术治疗神经根型颈椎病的临床应用[J].中国脊柱脊髓杂志, 2018,28(6):15-22.
[15] 王雪松, 张烽, 徐瑞生,等. 后路椎管减压植骨内固定治疗胸腰椎骨折合并脊髓损伤[J].中国矫形外科杂志, 2019, 27(14):1249-1253.
[16] 关晓明, 马迅. 脊髓型颈椎病手术入路及减压融合方式的选择策略[J].中华骨科杂志, 2019, 39(23):1478-1484.