摘要
目的:探讨Cervifix和Axis内固定系统对陈旧性寰枢椎脱位并脊髓不全损伤患者颈枕融合内固定治疗后神经功能恢复的影响。方法:西安市红十字会医院脊柱科、解放军第四军医大学西京医院骨科、解放军第四军医大学唐都医院骨科1998-08/2003-06收治的110例陈旧性寰枢椎脱位并脊髓不全损伤患者,均经前路或后路减压、后路融合,随机分组行Cervifix或Axis内固定。对两组治疗结果及围手术期参数、并发症比较研究。结果:围手术期参数:Cervifix组平均手术时间犤(125±25.3)min犦低于Axis组犤(168±19.5)min犦,差异有显著性意义(P<0.05);术中出血量Cervifix组犤(212±53.2)mL犦少于Axis组犤(421±50.6)mL犦,差异有显著性意义(P<0.05);术后引流量Cervifix组犤(50.4±15.8)mL犦少于Axis组犤(62.4±23.7)mL犦,差异有显著性意义(P<0.05)。两组无脊髓损伤加重、术后感染。全部患者均获骨性融合,术后JOA评分及优良率无差异。螺钉方向不佳:Cervifix组3枚,Axis组12枚,两者差异有显著性意义(χ2=7.007,P<0.05)。术后并发症:Cervifix组(0.752%)低于Axis组(5.504%),差异有显著性意义(χ2=18.11,P<0.05)。结论:两种内固定系统的融合率、神经功能恢复率无差异,Cervifix内固定优于Axis内固定。
AIM:To study the effects of Cervifix and Axis internal fixation system on the recovery of neurological function in patients with timeworn atlantoaxial dislocation accompanied by incomplete spinal cord injury after treatment of internal fixation of occipital cervical fusion. METHODS:The data of 110 patients with timeworn atlantoaxial dislocation and incomplete spinal cord injury, who were hospitalized in the spinal surgical department of Xi'an Red Cross Hospital,orthopaedic department of Xijing Hospital and Tangdu Hospital of the Fourth Military Medical University of Chinese PLA from August 1998 to June 2003,were analyzed.All the patients were performed with posterior or anterior decompression and posterior fusion followed by internal fixation with Cervifix or Axis system.The therapeutic efficacy,perioperative indexes and complications were compared between the two groups. RESULTS:Perioperative indexes:the average operating duration in the Cervifix group[(125± 25.3) minutes] was significantly shorter than that in the Axis group[(168± 19.5) minutes](P< 0.05); The volume of blood loss during operation was significantly less in the Cervifix group[(212± 53.2) mL] than in the Axis group[(421± 50.6) mL](P< 0.05);The postoperative drain volume in the Cervifix group[(50.4± 15.8) mL] was remarkably less than that in the Axis group[(62.4± 23.7) mL] (P< 0.05). There was no deteriorated spinal cord injury and infection after operation.All cases in the two groups obtained bony fusion.There was no difference in the postoperative JOA score and good evaluation between the two groups.The directions of screws were unsuitable,and there was significant difference between the Cervifix group(3 pieces) and Axis group(12 pieces)(χ 2 =7.007,P< 0.05).The incidence rate of postoperative complication in the Cervifix group(0.752% ) was markedly lower than that in the Axis group(5.504% )(χ 2 =18.81,P< 0.05). CONCLUSION:There are insignificant differences in the fusion rate and neurological functional recovery between the internal fix
出处
《中国临床康复》
CSCD
北大核心
2005年第6期26-28,共3页
Chinese Journal of Clinical Rehabilitation
