| 吕召民.颈椎椎板切除术联合侧块螺钉内固定治疗无骨折脱位型颈髓损伤.骨科,2016,7(6): 408-411. |
| 颈椎椎板切除术联合侧块螺钉内固定治疗无骨折脱位型颈髓损伤 |
| The laminectomy and lateral mass screws fixation for cervical spinal cord injury without fracture and dislocation |
| 投稿时间：2016-01-05 |
| DOI：10.3969/j.issn.1674-8573.2016.06.006 |
| 中文关键词: 颈椎 骨螺丝 内固定器 脱位 椎管狭窄 |
| 英文关键词: Cervical vertebrae Bone screws Internal fixators Dislocations Spinal stenosis |
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| 中文摘要: |
| 目的 探讨椎板切除术联合侧块螺钉内固定治疗无骨折脱位型颈髓损伤的临床疗效及临床意义。方法 回顾性分析2013年9月至2015年3月我院收治并应用椎板切除术联合侧块螺钉内固定治疗的无骨折脱位型颈髓损伤患者13例，其中男9例，女4例；年龄为39~68岁，平均为51.3岁。记录患者术中手术时间、出血量、术后并发症，记录颈部疼痛视觉模拟评分（visual analogue scale, VAS）评估临床症状，美国脊髓损伤协会（American Spinal Injury Association, ASIA）神经功能分级评估颈髓损伤情况。患者术前VAS评分平均为（7.2±1.0）分，术前ASIA神经功能分级：A级1例、B级3例、C级5例、D级4例。结果 所有患者手术均顺利完成，术后有1例患者出现伤口并发症，其余无严重并发症出现；手术时间为100~150 min，平均为120.1 min；失血量为140~700 ml，平均为350 ml。患者均获得随访，随访时间为6~16个月，平均为10.4个月。术后末次随访VAS评分平均为（1.2±0.7）分，与术前比较，差异有统计学意义（P＜0.05）。术后末次随访时AISA神经功能分级：B级1例、C级3例、D级4例、E级5例，均较术前改善。结论 椎板切除术联合侧块螺钉内固定手术创伤小、固定可靠、疗效确切，为治疗无骨折脱位型颈髓损伤较理想的手术方法。 |
| 英文摘要: |
| Objective To evaluate the efficacy, indication and clinical outcome of the treatment of cervical spinal cord injury without fracture and dislocation using laminectomy and lateral mass screws fixation. Methods A total of 13 patients with cervical spinal cord injury without fracture and dislocation were treated with laminectomy and lateral mass screws fixation in our department between September 2013 and March 2015, including 9 males and 4 females with age ranging from 39 to 68 years old (mean 51.3). The operation time, blood loss, postoperative complications, and visual analogue scale (VAS) were recorded, and neurological function was evaluated by the ASIA scale. Results All patients were followed up for 6-16 months with an average time of 10.4 months. The blood loss was 350 ml averagely (140-700 ml), and operation time was 120.1 min averagely (range: 100-150 min). The fusion rate was 100% postoperation. VAS scores were (7.2±1.0) preoperation, and (1.2±0.7) at last follow-up postoperation, there was statistically significant difference before and after operation (P＜0.05). As to the ASIA scale, there was 1 patient at grade A, 3 patients at grade B, 5 at grade C, and 4 at grade D before operation, and there was 1 patient at grade B, 3 patients at grade C, 4 at grade D and 5 at grade E after operation. Conclusion The laminectomy and lateral mass screws fixation is an effective and reliable procedure to be used in specific types of cervical spinal cord injury without fracture and dislocation, but strict indication is the key to this procedure. |
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