| Background:The definition of subaxial cervical facet joint injury refers to fracture and/or dislocation of subaxial cervical(C3-C7)facet joint,which is mostly caused by traffic accident injury or falling injury with high violence,and is often related to neurologic function damages.Because of its complicated injury mechanism,the correlation between the injury types of subaxial cervical facet joint injury and the degree of neurologic function damage is still unknown,as well as its influence on prognosis,.Objective:To explore the correlation between the types of the subaxial cervical facet joint injury and the degree of neurologic function damage and prognosis.Methods:The clinical,imaging and postoperative follow-up datum of 66 patients with fracture and dislocation of lower cervical facet treated in our hospital from February 2017 to May 2020 were analyzed retrospectively.According to the morphology of fractures and dislocations,the patients were divided into three groups: group A,there were fractures in the facet joints without no obvious displacements;group B,there were obvious fractures in the facet joints(fragment > 1 cm,> 40% articular surface)with displacements;group C,there were dislocations in facet joints without fractures(or with minor fractures,fragment ≤1 cm,≤40%articular surface).The clinical detum include: age,sex,injury type,operation option,preoperative and postoperative neurological function score(NF)and improvement rate(NFIR);Imaging measurement indexes include spinal canal sagittal diameter(SD),vertebral translocation distance(TD)and effective spinal canal sagittal diameter(e SD).Datum were analyzed statistically by SPSS : Chi-square test,T test,variance analysis and Kruskal-Wallis nonparametric rank sum test were used to analyze the discrepancy of the datum among the three groups.Pearson correlation analysis and linear regression analysis were used to analyze the correlation of datum.P < 0.05 was statistically significant.Results:A total of 66 patients were brought into this study,including 15 in group A,19 in group B and 32 in group C..The age of group C was(53.69 9.25),which was significantly higher than that of group A(43.5313.01,p < 0.05)and group B(44.47 12.02,p < 0.05).There was no significant difference in sex composition among the three groups.There were 29 patients with lower neurological function(NF≤5,ASIA grade A-C)and 37 patients with higher neurological function(NF≥6,ASIA grade D-E)before operation.All the patients with high preoperative neurological function recovered to normal sensorimotor function except 2 cases with slight increase of residual muscle tension.Among the patients with low preoperative neurological function,3patients(NF=2)died within 6 months(the cause of death is unknown),1patient(NF=2)did not recover significantly,and other patients were improved in different degrees.The preoperative nerve function score(pre NF)of group C was significantly lower than that of group A(6,P <0.05)and group B(6,P < 0.05).There was no significant difference in other parameters among the three groups.Furthermore,the differences of imaging parameters among the three groups and their relationship with the degree of neurological impairment were analyzed.The e SD in group C was(7.95±3.93mm),which was significantly lower than that in group A(12.12±2.73 mm,p < 0.05),but there was no significant difference with that in group B(10.14±2.38 mm,p < 0.05).There is a significant positive correlation between the e SD and the pre NF,with a coefficient of(0.374),while there is no significant correlation between the e SD and the NFIR.Conclusion:1.The fracture and dislocation types of subaxial cervical facet joints are affected by age.2.The degree of neurological damage of the patients with facet joint dislocation is more serious than that of the patients with facet joint fracture.3.The effective sagittal diameter of spinal canal is one of the risk factors of preoperative neurological impairment. |
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