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强直性脊柱炎患者颈椎骨折脱位治疗中头环背心复位与颅骨牵引复位的对比研究

Comparative study of halo-vest reduction and skull traction reduction in the treatment of cervical fracture dislocation in patients with ankylosing spondylitis.

作者信息

Wang Liang, Wang Haibin, Wang Can, Zhang Bangke, Yang Haisong, Lu Xuhua

机构信息

School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.

Department of Orthopaedics, Second Affiliated Hospital of Naval Medical University, Shanghai, China.

出版信息

Front Surg. 2023 May 9;10:1129809. doi: 10.3389/fsurg.2023.1129809. eCollection 2023.

Abstract

BACKGROUND

This study aimed to investigate the safety and efficacy of the halo-vest in the treatment of cervical fracture in patients with ankylosing spondylitis (AS) and kyphosis.

METHODS

From May 2017 to May 2021, 36 patients with cervical fractures with AS and thoracic kyphosis were included in this study. The patients with cervical spine fractures with AS underwent preoperative reduction by halo-vest or skull tractions. Instrumentation internal fixation and fusion surgery were then performed. The level of cervical fractures, the operative duration, blood loss, and treatment outcomes were investigated preoperatively and postoperatively.

RESULTS

A total of 25 cases were included in the halo-vest group and 11 cases were included in the skull tractions group. The intraoperative blood loss and the surgery duration were significantly less in the halo-vest group than in the skull traction group. A comparison of American Spinal Injury Association scores at admission and final follow-up showed that the neurological function of patients improved in both groups. All patients had reached solid bony fusion during the follow-up.

CONCLUSION

This study presented a unique approach to use halo-vest treatment fixation of unstable cervical fracture in patients with AS. The patient should also have early surgical stabilization with a halo-vest to correct spinal deformity and avoid worsening of neurological status.

摘要

背景

本研究旨在探讨头环背心在强直性脊柱炎(AS)合并脊柱后凸患者颈椎骨折治疗中的安全性和有效性。

方法

2017年5月至2021年5月,本研究纳入了36例患有AS和胸椎后凸的颈椎骨折患者。患有AS的颈椎骨折患者术前通过头环背心或颅骨牵引进行复位。然后进行器械内固定和融合手术。术前和术后对颈椎骨折水平、手术时间、失血量和治疗结果进行了研究。

结果

头环背心组共纳入25例,颅骨牵引组共纳入11例。头环背心组术中失血量和手术时间明显少于颅骨牵引组。入院时和最终随访时美国脊髓损伤协会评分的比较表明,两组患者的神经功能均有改善。所有患者在随访期间均实现了牢固的骨融合。

结论

本研究提出了一种独特的方法,即使用头环背心治疗AS患者不稳定颈椎骨折的固定。患者还应尽早使用头环背心进行手术稳定,以纠正脊柱畸形并避免神经状态恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e46/10203474/ec74216a0e15/fsurg-10-1129809-g001.jpg

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