不同手术入路治疗外伤性下颈椎骨折脱位的疗效比较

目的探讨下颈椎脱位手术入路疗效。方法回顾分析2005年1月至2013年6月收治的下颈椎脱位患者191例,分别采用前路、后路或前后联合入路的方式进行手术治疗,比较手术时间、出血量、术后3个月颈髓损伤日本骨科协会评估治疗分数（JOA）评分和肺部感染发生率。结果术后随访3-9个月,平均5个月,前路、后路或前后联合入路之间比较或是两两之间比较,手术时间、出血量差异均有统计学意义,而术后3个月颈髓损伤JOA评分和肺部感染发生率差异无统计学意义,同组之间术前、术后JOA评分比较差异具有统计学意义。结论下颈椎脱位治疗选择合适的手术方式获得相同的疗效,并可缩短手术时间和减少组织损伤。

Efficacy comparative study of different treatments for fracture and dislocation of the lower cervical spine

Objective To discuss the effects of surgical approaches in treating the dislocation of lower cervical spine.Methods A retrospective study was performed on data of 191 patients with dislocation of the lower cervical spine admitted to our hospital from January 2005 to June 2013.The patients were treated with anterior surgical approach,posterior surgical approach or combined anterior and posterior surgical approach.The operative time,blood loss,JOA scores of cervical spinal cord injury in three months after operation and the infection rate of lung were compared.Results The patients were followed up for 3-9 months（average 5 months）.Between anterior,posterior or combined anterior and posterior surgical operation,or between two groups was done,the operative time and blood loss had statistically significant difference,but there was no significant difference in the JOA scores of cervical spinal cord injury in three months after operation and the infection rate of the lunge.In addition,there was significant difference in JOA scores before and after operation in the same group.Conclusion The suitable surgical approaches in treating lower cervical dislocation gained the same effects as well as reduced the operative time and alleviated the tissue injury.