摘要
目的比较植骨与否在椎弓根螺钉内固定治疗Ⅱ型齿状突骨折的近期临床疗效。方法对14例Ⅱ型齿状突骨折8例（A组）行后入路椎弓根钉复位固定，椎板间自体髂骨植骨；6例（B组）单纯行后入路椎弓根螺钉内固定。观察手术时间、手术出血量及术后第3个月颈椎屈伸及旋转功能，并随访5-45个月。结果所有患者获得随访时间5—45个月，平均26．5个月。植骨组手术时间（1．83±0．50）h，非植骨组手术时间（1．58±0．90）h，两组差异有统计学意义（t=2．842，P〉0．05）。植骨组出血（150±16）mL，非植骨组出血（120±14）mL，两组差异有统计学意义（t=3．57，P〉0．05）。3个月后植骨组颈椎屈曲（31．2±4．6）°，非植骨组颈椎屈曲（32．3±5．7）°，两组差异有统计学意义（t=0．675，P〈0．05）。植骨组旋转（40．6±4．5）°，非植骨组旋转（41．3±3．5）°，两组差异有统计学意义（t=0．278，P〈0．05）。两组均无椎动脉和脊髓损伤，伤口一期愈合。随访期间两组患者颈椎复位良好，无内固定松动、断裂、骨折愈合好，A组植骨块融合。结论对于该类型骨折单纯行寰枢椎椎弓根内固定相比较联合自体髂骨植骨融合治疗，可节省手术时间、减少出血量。
Objective To explore the clinical efficacy of bone grafting in the treatment of type II odontoid fracture with pedicle screw fixation. Methods Of 14 cases with type II odontoid fractures, 8 patients in group A received pedicle screw, lamina autologous bone grafts, 6 cases of group B received simple posterior pedicle screw fixation. The operative time, the amount of surgical bleeding and the postoperative cervical spine flexion and rotation were observed at 3 months postoperatively, and the patients were followed up for 5 - 45 months. Results All patients were followed up for 5 -45.months,with an average of 26.5 months. The operation time was （ 1.83 ±0.5）h in the bone graft group, and （ 1.58 ± 0.9 ） h in the non - bone graft group, the difference was statistically significant （ t = 2. 842,P 〉 0. 05 ）. The blood loss of the bone graft group was （ 150 ± 16） mL, which of the non - bone graft group was （120±14） mL, the difference between the two groups was statistically significant （t = 3.57,P 〉 0. 05）. After 3 months,the flexion of the cervical spine of the bone graft group was （31.2 ±4.6）°,which in the non -grafted group was （32.3 ± 5.7） °, the difference was statistically significant （ t = 0.675, P 〈 0.05 ）. The rotation of the bone graft group was （40.6 ± 4.5）°, which in the non- graft group was （41.3 ± 3.5.）°, the difference was statistically significant （t = 0. 278, P 〈 0.05）. Both two groups had no vertebral artery and spinal cord injury, wound healing. During the follow - up period, the two groups of patients had a good reduction of cervical spine, no internal fixation lossening, fracture, fracture healing well, group A bone graft fusion. Conclusion For this type of fracture, simple aflantoaxial pedicle screw fixation compared with autologous iliac bone graft fusion treatment, can save the operation time, reduce the amount of bleeding.
作者
李洪彪
孙秀芹
聂文波
翟喜成
秦磊
刘宝帅
Li Hongbiao, Sun Xiuqin,Nie Wenbo, Zhai Xicheng, Qin Lei, Liu Baoshuai.(Department of Orthopedics, the Central Hospital of Shan County, Lake West Hospital Affiliated to Jining Medical College,Shandong 274300, China （ Li liB, Sun XQ, Nie WB, Zhai XC, Qin L, Liu BS） ; Heze Home Economics Vocational College, Shandong 274300, China （ Sun XQ)
出处
《中国基层医药》
CAS
2018年第8期1002-1005,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
骨折
椎弓根钉
颈椎骨
Fracture,bone
Pedicle screw
Cervical vertebrae
