本文選題：頸椎 + 骨折　； 參考：《中國矯形外科雜志》2017年08期

【摘要】：[目的]分析證明頸前路撐開螺釘提拉復位技術較常規(guī)前路復位技術在治療外傷性頸椎骨折脫位的優(yōu)勢。[方法]收集2008年1月~2014年6月采用Ⅰ期前路治療牽張屈曲分離型雙側關節(jié)突交鎖的86例外傷性頸椎骨折脫位患者,男54例,女32例;年齡20~73歲,平均(40.1±5.6)歲。按照入院順序分配到頸前路常規(guī)復位(44例)和頸前路撐開螺釘提拉復位(42例)。比較兩組間術中出血量、手術時間、術后椎體復位率,術后隨訪12~18個月,通過Frankel’s評分、JOA評分、VAS評分對其療效進行評定。[結果]兩組手術時間及頸椎脫位矯正率的組間比較差異有統計學意義(P0.05),提拉復位組優(yōu)于常規(guī)復位組。兩組術后Frankel’s評分、VAS評分、JOA評分均較術前明顯改善,差異有統計學意義(P0.05);三項評分組間比較差異無統計學意義(P0.05)。[結論]頸前路撐開螺釘提拉復位技術操作簡單、操作風險低、手術時間短,術中椎體復位效果及術后功能恢復良好,同時可減少常規(guī)復位法中因撬撥或復位中關節(jié)彈跳引起的頸髓醫(yī)源性損傷及術后并發(fā)癥,是一種安全有效的治療頸椎骨折脫位的手術方法,較常規(guī)手術復位組有明顯優(yōu)勢,中長期隨訪頸椎穩(wěn)定性良好,適合臨床推廣應用。
[Abstract]:[objective] to prove the advantage of anterior cervical distraction screw lifting reduction technique in the treatment of traumatic cervical fracture and dislocation. [methods] from January 2008 to June 2014, 86 patients (54 males and 32 females) with traumatic cervical fracture and dislocation were treated with stage I anterior approach. The average age was 40.1 鹵5.6 years, aged 20 to 73 years. According to the order of admission, 44 cases were assigned to the anterior cervical approach (n = 44) and 42 cases to the anterior cervical open screw lifting reduction (n = 42). The amount of blood loss, the time of operation, the rate of reduction of vertebral body after operation were compared between the two groups. The curative effect was evaluated by Frankelos score and JOA score and VAS score after follow-up for 12 ~ 18 months. [results] the difference of operation time and cervical dislocation correction rate between the two groups was statistically significant (P 0.05), and the lifting reduction group was superior to the conventional reduction group. The scores of Frankelos and VAS and JOA in the two groups were significantly improved compared with those before operation, and the difference was statistically significant (P 0.05), but there was no significant difference among the three groups (P 0.05). [conclusion] the technique of lifting reduction of anterior cervical distraction screw is simple, low risk, short operation time, good reduction effect during operation and good recovery of function after operation. At the same time, it can reduce the iatrogenic injury and postoperative complications of cervical spinal cord caused by prying or joint bounce in conventional reduction. It is a safe and effective surgical method for the treatment of fracture and dislocation of cervical vertebra, and has obvious advantages over conventional surgical reduction group. The long-term follow-up of cervical vertebrae is stable and suitable for clinical application.
【作者單位】： 同濟大學附屬東方醫(yī)院脊柱外科;中國人民解放軍第303醫(yī)院;
【基金】：國家自然基金資助項目(編號:81371994) 浦東新區(qū)衛(wèi)生系統重點學科建設資助項目(編號:PWZx2014-02)
【分類號】：R687.3

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