椎间盘镜下与开放式中空螺钉内固定治疗齿状突骨折的对照研究

目的　比较椎间盘镜下与开放式中空螺钉内固定治疗齿状突骨折的优缺点。方法　对 8例采用椎间盘镜下中空螺钉内固定(椎间盘镜组)与 14例开放式中空螺钉内固定 (开放手术组 )治疗的齿状突骨折病例进行回顾性分析,比较两组的手术切口大小、手术时间、术中出血量、术中透视次数,术后骨折愈合时间、愈合率以及颈椎的活动度。结果　椎间盘镜组的手术切口平均 1. 62cm、手术时间 75min、出血量 20 .5ml,均小于开放手术组(P<0. 05)。两组的骨折愈合率、颈椎活动度差异无显著性 (P>0. 05)。结论　椎间盘镜下直接中空螺钉内固定术创伤较小,手术操作方便,能简化手术,缩短手术时间,减少出血量。

The comparative study of microendoscopic discectomy system and anterior open approach in the treatment of internal fixation of odontoid fracture with cannulated screw

Objective To compare the advantages and disadvantages of microendoscopic discectomy system and open approach internal fixation of odontoid process fracture with cannulated screw. Methods 8 cases were treated under microendoscopic discectomy system (MED Group)and 14 cases with anterior open approach (Open Group). The incision size,operating time, blood loss, fluoroscopy frequency in operation, healing time of fracture, healing rate of fracture and cervical rang of motion were compared. Results The average length of incision was 1.62 cm in MED group and 6.5 cm in anterior in Open Group. Average operating time was 75 minutes and average blood loss was 20.5 ml in MED Group, which were less than those in Open Group (P<0.05). Healing rate of odontoid process fracture and cervical rang of motion in the two groups had no statistical diference(P>0.05). Conclusions The internal fixation of odontoid process fracture with cannulated screw under microendoscopic discectomy system requires simple operative manipulation and less trauma and so operating time and blood loss could be reduced.