齿状突骨折手术方式的选择及治疗效果分析

目的:通过回顾性分析齿状突骨折不同术式的疗效,从而指导后期临床治疗。方法:回顾分析齿状突骨折26例,对比观察前、后路手术时间、出血量、平均住院时间及术后疼痛数字评分、颈椎功能障碍指数评分(NDI)等指标。结果:前路齿状突螺钉内固定手术时间105.7±35.3 min、出血量62.1±18.5 mL、平均住院时间7.0±1.9天、疼痛数字评分3.6±1.7分、NDI 24.3%±11.7%,后路寰枢椎融合手术时间148.2±36.2 min、出血量338.4±143.3 mL、平均住院时间11.2±2.1天、疼痛数字评分5.1±1.4分、NDI33.6%±13.4%。结论:前路齿状突螺钉内固定术具有手术时间短、出血少、平均住院时间短、疼痛数字评分低、对颈椎活动功能影响小等优势,而后路寰枢椎融合术具有手术适应范围广、手术操作难度小等优势,而其对颈椎活动功能影响较大。

Different Operation Methods for Odontoid Fracture and the Curative Effect Analysis

Objective:To analyze the curative effect of odontoid fracture through different operative methods, and then to guide the subsequent clinical treatment of odontoid fracture.Methods:We analyzed 26 cases of odontoid fracture, and assessed operation time, bleeding volume, average hospitalization time, postoperative pain score, and neck disability index score ( NDI ).Results:The operation time was 105.7 ± 35.3 min, the bleeding volume was 62.1± 18.5 mL, the average time of hospitalization was 7± 1.9 days, pain score was 3.6± 1.7, NDI was 24.3 ± 11.7% in odontoid screw fixation group. And the operation time was 148.2 ± 36.2 min, the bleeding volume was 338.4± 143.3 ml, the average time of hospitalization was 11.2± 2.1 days, pain score was 5.1 ± 1.4, NDI was 33.6 + 13.4% in the posterior atlantoaxial fusion group.Conclusion:The method of odontoid screw fixation has the advantages of shorter operation time, less bleeding, shorter hospitalization time, lower pain score, and less effect on cervical function. However, the method of atlantoaxial fusion is adapted to a wide range of odontoid fracture, and the operation is not much difficult. But this method has much influence on cervical activity.