Efficacy of Anterior-Posterior Combined Approach Decompression, Reduction, Fusion and Internal Fixation in the Treatment of Cervical Fracture-Dislocation Complicated with Spinal Cord Injury
LUO Sijin, WANG Hui, LIANG Hongnian
Department of Spinal and Orthopedic Surgery, Hechi People's Hospital, Hechi Guangxi 547000
Abstract：【Objective】To explore the efficacy of anterior-posterior combined approach decompression, reduction, fusion and internal fixation in the treatment of cervical fracture-dislocation (FDLCS) complicated with spinal cord injury (SCI).【Methods】A retrospective analysis was conducted on 100 patients with FDLCS complicated with SCI who underwent decompression, reduction, fusion and internal fixation in our hospital from January 2019 to January 2023. According to the surgical approach, they were divided into the anterior approach group (anterior approach surgery, n=48) and the combined group (anterior-posterior combined approach surgery, n=52). The perioperative indicators, imaging indicators, bone graft fusion, therapeutic effect, spinal nerve recovery and complications were compared between the two groups.【Results】The operation time and hospital stay in the combined group were longer than those in the anterior approach group, and the intraoperative blood loss and postoperative drainage volume were higher than those in the anterior approach group (P<0.05). After surgery, the average Cobb angle and intervertebral slip distance in the combined group were smaller than those in the anterior approach group (P<0.05). There was no significant difference in the bone graft fusion rate and average fusion time between the combined group and the anterior approach group (P>0.05). The total effective rate of the combined group was higher than that of the anterior approach group (P<0.05). After surgery, the Japanese Orthopaedic Association (JOA) score in the combined group was higher than that in the anterior approach group (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). 【Conclusion】The anterior-posterior combined approach decompression, reduction, fusion and internal fixation for patients with FDLCS complicated with SCI has greater trauma, higher operational difficulty and slower postoperative recovery, but the combined approach can better restore the cervical anatomical structure, with better postoperative neurological function recovery and better curative effect, and higher safety. Clinicians can choose the appropriate approach according to the individual situation of patients.
罗思进, 汪慧, 梁洪念. 前后联合入路减压复位融合内固定术治疗颈椎骨折脱位合并脊髓损伤的疗效[J]. 医学临床研究, 2025, 42(7): 1164-1167.
LUO Sijin, WANG Hui, LIANG Hongnian. Efficacy of Anterior-Posterior Combined Approach Decompression, Reduction, Fusion and Internal Fixation in the Treatment of Cervical Fracture-Dislocation Complicated with Spinal Cord Injury. JOURNAL OF CLINICAL RESEARCH, 2025, 42(7): 1164-1167.
[1] 宋晓飞,刘念,刘瑜,等.显微镜辅助治疗下颈椎骨折脱位并脊髓损伤[J].中国矫形外科杂志, 2023, 31(14):1270-1274.
[2] 仇胥斌,袁晓峰,庄明.前路减压复位融合内固定治疗颈椎骨折脱位合并脊髓损伤的临床效果及对影像学参数、并发症的影响[J].解放军医药杂志,2021,33(12):47-50.
[3] BAXTER J, LISK R, OSMANI A, et al. Clinical outcomes in patients admitted to hospital with cervical spine fractures or with hip fractures[J].Intern Emerg Med,2021,16(5):1207-1213.
[4] 梁树威,林树体,黄家良,等.两种入路手术治疗强直性脊柱炎合并下颈椎骨折脱位的疗效比较[J].临床骨科杂志,2022,25(3):310-313.
[5] 张万乾,王想福,郑卉卉,等.经皮内镜辅助下椎弓根内固定治疗腰椎爆裂骨折并脊髓损伤1例[J].中国现代手术学杂志,2021,25(5):396-398.
[6] 康永生,梅伟,王庆德,等.Ⅰ期前路颈椎复位减压及椎间植骨融合内固定术治疗下颈椎AO C型F4亚型单节段损伤[J].中华创伤杂志,2021,37(2):107-113.
[7] 占道禄,林明侠,林庆彪,等.前后路联合手术固定治疗严重下颈椎骨折脱位疗效观察[J].海南医学,2017,28(18):2978-2981.
[8] MELUZIO M C, BORRUTO M I, PERNA A, et al. Emergency treatment of cervical vertebromedullary trauma: 10 years of experience and outcome evaluation[J].Acta Neurochir Suppl,2023,135:315-319.
[9] 胡安文,曹纬,胡天瑞,等.后路带蒂筋膜脂肪片修复硬脊膜损伤联合持续引流在严重脊髓型颈椎病前后联合入路手术中的应用[J].中国骨与关节损伤杂志,2023,38(1):50-52.
[10] 徐亮,马厦,曾祥一.颈椎前后联合入路手术治疗多节段脊髓型颈椎病的临床研究[J].中国现代医学杂志, 2023, 33(21):73.
[11] 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.
2025, Vol. 42 
