مقايسه نتايج باليني دو روش درمان جراحي قدامي يا خلفي در شكستگي هاي ادونتوئيد تيپ II

Comparative Clinical Results of Surgical Approach Anterior Versus Posterior Fusion

در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﺑﺮرﺳﯽ ﮔﺬﺷﺘﻪﻧﮕﺮ و ﻣﻘﺎﯾﺴﻪ ﺑﯿﻤﺎراﻧﯽ ﭘﺮداﺧﺘﻪاﯾﻢ ﮐﻪ ﺗﺤﺖ درﻣﺎن ﺷﮑﺴﺘﮕﯽﻫﺎي ادوﻧﺘﻮﺋﯿﺪ ﺗﯿﭗ 2 ﺑﻪ دو روش ﻗﺪاﻣﯽ و ﺧﻠﻔﯽ ﻗﺮار ﮔﺮﻓﺘﻪاﻧﺪ. روش ﮐﺎر در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮔﺬﺷﺘﻪﻧﮕﺮ و ﻣﻘﻄﻌﯽ، ﺑﯿﻤﺎران ﺑﺎ ﺳﻦ زﯾﺮ 65 ﺳﺎل ﮐﻪ ﺗﺤﺖ ﻋﻤﻞ ﺟﺮاﺣﯽ ﺑﺎ روش ﻗﺪاﻣﯽ و ﺧﻠﻔﯽ ﺑﺮاي درﻣﺎن ﺷﮑﺴﺘﮕﯽ ادﻧﺘﻮﺋﯿﺪ ﺗﺎﯾﭗ دو و اﻧﻮاع ﺳﺎب ﺗﺎﯾﭗ آن ﻗﺮارﮔﺮﻓﺘﻨﺪ، وارد ﻣﻄﺎﻟﻌﻪ ﺷﺪﻧﺪ. اﻃﻼﻋﺎت و آزﻣﺎﯾﺸﺎت ﻻزم ﺷﺎﻣﻞ رادﯾﻮﮔﺮاﻓﯽ AP ،open mouth، ﻟﺘﺮال و ﺳﯽﺗﯽ اﺳﮑﻦ در ﺻﻮرت ﻧﯿﺎز و ﻫﻤﭽﻨﯿﻦ اﻃﻼﻋﺎت دﻣﻮﮔﺮاﻓﯿﮏ، ﻣﮑﺎﻧﯿﺴﻢ آﺳﯿﺐ، وﻗﻮع ﻋﻼﺋﻢ ﻧﻮروﻟﻮژﯾﮏ در زﻣﺎن ﭘﺬﯾﺮش، ﻃﻮل ﻣﺪت ﺑﺴﺘﺮي در ﺑﺨﺶ و ICU، ﻃﻮل زﻣﺎن ﺟﺮاﺣﯽ ﺗﮑﻤﯿﻞ ﮔﺮدﯾﺪ. اﻃﻼﻋﺎت ﺑﻌﺪ از ﺟﻤﻊ آوري در ﻧﺮم اﻓﺰار SPSS وارد ﺷﺪه و ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ آﻣﺎري ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﻧﺘﺎﯾﺞ از 39 ﺑﯿﻤﺎر، 25 ﻧﻔﺮ از ﺑﯿﻤﺎران ﻣﺬﮐﺮ )64/1%( و 14 ﻧﻔﺮ )35/9%( ﻣﺆﻧﺚ ﺑﻮدﻧﺪ. ﻣﺪت زﻣﺎن ﺑﺴﺘﺮي در ICU و ﻣﺪت زﻣﺎن ﺟﺮاﺣﯽ در ﮔﺮوه ﺧﻠﻔﯽ ﺑﻪﻃﻮر ﻣﻌﻨﯽداري ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﻗﺪاﻣﯽ ﺑﯿﺸﺘﺮ ﺑﻮد )0/05

Introduction: In this retrospective study, we compared odontoid fractures type two patients treated with two methods of anterior and posterior surgery. Methods: In this cross-sectional retrospective study, 39 patients under 65 years old with odontoid fractures type two and its subtypes witch had anterior and posterior surgery were included in the study. Necessuray experiments and information included open mouth radiography, AP, letral and CT scan if needed, and also demographic information, mechanism of injury, occurrence of neurologic symptoms at the time of admission, the length of hospital and ICU stay, and length of surgery were completed. Finally, the data were analyzed by SPSS software. Results: Among 39 pateints, 25(64.1%) were male and 14(35.9%) were female. The length of ICU stay and surgery in posterior group were significantly higher than anterior group (p<0.05). Any complications such as: displacement, loosening, CSF fistula, esophageal rupture, hypoglossal nerve rupture were not not created or exacerbated. Fusion rate in 12 month was sinnificantly higher in posterior group but after 24 month there was not any significant changes between two groups. Conclusion: According to the results, posterior surgery is the standard and selective method for the treatment of these odontoid type two fractures which have good clinical results and fewer complications.