巴基斯坦KPK三级医院外伤性亚轴颈椎损伤的流行病学和手术结果

Hamayun Tahir, Naseer Hassan, Afzal Raza, Hina Arooj, Samina Feroz, Farooq Azam
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摘要

目的:本研究的目的是描述巴基斯坦开伯尔-普赫图赫瓦省一家三级医院的流行病学特征、外伤性下颈椎损伤的模式及其手术结果。材料和方法:本回顾性描述性研究在白沙瓦雷丁夫人医院神经外科进行。对40例年龄在15 - 60岁之间的颈椎损伤患者的记录进行评估,以确定损伤和手术结果。我们经常采用前路手术,只有在复位失败或严重不稳定时才采用后路手术。我们使用三皮质骨移植物或钛笼与自体骨,并通过钛板固定它们以实现融合。结果:80%的患者表现为颈椎亚轴性损伤。至于受伤的原因,37.5%曾因机动车辆事故受伤,28.12%曾因高空坠落受伤,其余则因其他原因受伤。68.75% (n = 22)的患者发生了孤立性半脱位损伤,87.5% (n = 28)的患者接受了手术干预;术后疼痛缓解等手术结果采用VAS评分,术前为6.09±1.42,术后为4.5±1.29,均值差为1.59。通过ASIA损伤量表测量,神经功能有显著改善。结论:颈椎损伤以年轻男性为主,以机动车事故为主,孤立性半脱位为最常见的损伤类型。
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Epidemiology and Surgical Outcome of Traumatic Sub Axial Cervical Spine Injuries in a Tertiary Care Hospital of KPK, Pakistan
Objective:  The purpose of this study was to characterize the epidemiologic characteristics, a pattern of traumatic subaxial cervical spine injuries, and their surgical outcomes in a tertiary care hospital in Khyber Pakhtunkhwa, Pakistan. Materials and Methods:  This retrospective descriptive study was conducted at the Department of Neurosurgery at Lady Reading Hospital Peshawar. The records of 40 patients between the ages of 15 and 60 who had cervical spine injuries were evaluated to characterize the injuries and surgical outcomes. We employed the anterior route for surgery regularly and the posterior method only when the reduction failed or substantial instability. We used a tricortical bone graft or titanium cages with autologous bone and secured them through titanium plates to achieve fusion. Results:  80% of patients presented with sub axial cervical injury. Regarding the etiology of injury, 37.5 % had motor vehicle accidents, 28.12% had a history of height falls, and the remaining had sustained injuries due to other causes. The majority of the patients, 68.75% (n = 22), had isolated subluxation injury.87.5% (n = 28) underwent surgical intervention; surgical outcomes such as pain relief were measured using the VAS, which was 6.09 ± 1.42 preoperatively while 4.5 ± 1.29 postoperatively with a difference of means of 1.59. There was a significant improvement in neurological functions as measured through the ASIA impairment scale. Conclusion:  Most cervical spine injuries occurred in young male patients, motor vehicle accidents were the most prevalent cause, and isolated subluxation was the most frequent injury pattern.   
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