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| 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 |
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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.
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Received: 27 April 2025
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2025, Vol. 42 
