Rehman Lal, Bukhari Iram, Afzal Ali, Rizvi Raza
Dr. Lal Rehman, FCPS. Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Dr. Iram Bukhari, FCPS. Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Pak J Med Sci. 2017 Nov-Dec;33(6):1355-1359. doi: 10.12669/pjms.336.12947.
OBJECTIVE: To determine clinical outcome in patients with cervical injury after lateral mass screws fixation in a tertiary care hospital. METHODS: This study included 88 patients, with cervical injury confirmed radiologically. Patients <12 or >70 years, with traumatic discs, cord compression without subluxation and previously operated on cervical spine were excluded from this study. All patients underwent fixation with lateral mass screws through posterior approach under fluoroscopic guidance. Frankel grading was used to assess the clinical status of these patients pre-operatively & post-operatively. RESULTS: There were 60(68.18%) males and 28(31.8%) females. The ages varied from 18 to 55 years with a mean of 32 yrs ± 8 yrs. The most common level of injury was C5-C6 in 46(52%) patients. According to Frankel grading system, 35 (39.8%) patients were placed in Grade A, 15(17.05%) in Grade B, 22(25%) in Grade C, 12 (13.6%) in Grade D, four (4.5%) in Grade E on admission. Postoperatively, 16 (18.2%) patients were placed in Grade A, 23 (26.1%) in Grade B, eight (9.1%) in Grade C, nine (10.2%) in Grade D and 26(29.6%) patients in Grade E with an overall improvement in neurological function in 51(58%) and power in 37(42%) patients. The major complications encountered were respiratory infections in 10(11.36%) and wound infection in four (4.5%) while eight (9.1%) patients expired. CONCLUSION: Lateral mass screws technique is a safe and effective method for cervical fixation after proper reduction.
目的:在一家三级护理医院中确定接受侧块螺钉固定术的颈椎损伤患者的临床结局。 方法:本研究纳入88例经放射学确诊为颈椎损伤的患者。年龄小于12岁或大于70岁、伴有外伤性椎间盘、无半脱位的脊髓受压以及既往有颈椎手术史的患者被排除在本研究之外。所有患者均在透视引导下通过后路行侧块螺钉固定术。采用Frankel分级法评估这些患者术前和术后的临床状况。 结果:男性60例(68.18%),女性28例(31.8%)。年龄范围为18至55岁,平均年龄32岁±8岁。最常见的损伤节段为C5-C6,共46例(52%)患者。根据Frankel分级系统,入院时35例(39.8%)患者为A级,15例(17.05%)为B级,22例(25%)为C级,12例(13.6%)为D级,4例(4.5%)为E级。术后,16例(18.2%)患者为A级,23例(26.1%)为B级,8例(9.1%)为C级,9例(10.2%)为D级,26例(29.6%)患者为E级,51例(58%)患者神经功能总体改善,37例(42%)患者肌力改善。主要并发症包括10例(11.36%)发生呼吸道感染,4例(4.5%)发生伤口感染,8例(9.1%)患者死亡。 结论:侧块螺钉技术是颈椎骨折复位后进行固定的一种安全有效的方法。
Pak J Med Sci. 2017
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