| Objective:Atlantoaxial Dislocation is a common disease, upper cervical vertebral clinically can be shown as pillow neck pain, limb numbness, or weakness, respiratory failure or paralysis, etc. Because atlas posterior atlantoaxial dislocation with high spinal cord compression, more potential nerve, spinal cord injury risk is higher, more take surgical treatment, if not timely and effective treatment, may lead to permanent neurological damage and sagittal plane deformity, serious life-threatening. So far there have been a lot of domestic and foreign literature reported atlantoaxial dislocation vertebra anatomy, surgical approach, surgical instruments and postoperative fusion rate, etc., but the quality of patients life still less research to improve the situation and its correlation factors. Operative treatment of patients with a fundamental purpose is to improve the quality of survival, enable patients to return to normal life, study and work, but what is concerning clinical doctors after surgery patients life quality improvement and influence factors, there’s almost no literature reports. A preliminary analysis of quality of life evaluation in the surgical treatment of atlantoaxial vertebral dislocation necessity and feasibility of surgical treatment for atlantoaxial vertebral dislocation comprehensive evaluation system to provide the basis.Methods:Our hospital from March 2014 to March 2014 were met inclusion and exclusion criteria of atlanto-axial dislocation, a total of 97 cases of patients with vertebral, according to the random sampling, a total of 47 cases were screened out,6 cases were lost to follow-up, all patients with preoperative and postoperative 3 month and 6 month after operation, postoperative JOA scores were used respectively to December, ASIA score, VAS score and modified SF-36 to evaluate the quality of life scale. By the literature, it would be to introduce the following eight factors:age (years old), gender (male/female), the length of the course of the disease (June or＞ 6 months or less), preoperative JOA score, high preoperative cervical MRI T2 signal (yes or no), surgical approach (through the mouth or posterior), surgical blood loss, operating time in the end, through statistical analysis of atlanto-axial dislocation vertebra postoperative quality of life and the correlation of different factors.Results:Study by random sampling, a total of 47 patients atlanto-axial dislocation patients with vertebral, among them 6 cases were lost to follow-up, cases of complete a total of 41 cases, collected data of 20 patients with male female 21 cases (P＜0.05), with an average age of 43.76±15.95 years, average operation time and blood loss were 204.61 63.38 mm (min),166.83±111.81 (ml);The average hospitalization days 15.15±6.61 (d);Preoperative and postoperative JOA score 1 year were 9.63±3.29 points,3.29±2.80 points, obviously improved compared with preoperative, postoperative statistically significant (P＜0.05); In December of preoperative and postoperative VAS score were 5.91 ±.05 points,5.91±.74 points, compared with postoperative and preoperative obviously improved statistically significant (P＜0.05);Patients with preoperative physiological function, physiological function, body pain, general health, energy, social function, emotional function, mental health were 48.29±27.69、29.88±.18、28.20±20.61、39.41±19.94、40.85±23.69、 43.90±32.49、21.13±33.95、40.20±18.64,1 year postoperatively in patients with physiological function, physiological function, body pain, general health, energy, social function, emotional function, mental health were 90.97 ±14.23、80.49±.55、93.56±13.62、77.37±18.81、89.51±11.45、79.88±19.54、 60.13±30.93、39.90±19.59, including the physiological function, physiological function, body pain, general health, energy, social function, emotional function compared with preoperative obviously improved, and statistically significant (P＜0.05);In December before and after operation, physical health score 35.56±16.76、16.76±12.66, respectively, the improving trend compared with preoperative, postoperative statistically significant (P＜0.05);Before and after operation, mental health scores were 36.61±20.94 in December,63.37±11.84, the improving trend compared with preoperative, postoperative statistically significant (P＜0.05). The orderly classification Logistic regression analysis, postoperative physical health and negatively correlated with duration (correlation coefficient= 3.061, P =3.061＜0.05), and negatively correlated with age (correlation coefficient =0.102, P=0.102＜0.05), and JOA scores were positively correlated (correlation coefficient of 1.173, P=0.021＜0.05), and negatively correlated with the course of mental health (correlation coefficient= 2.106, P= 2.106 ＜0.05).Conclusion:JOA score, physical health and mental health than preoperative improvement. Atlanto-axial dislocation with mild-to-moderate nerve function damage in patients with vertebral postoperative mental health improvement related to the course of the disease, postoperative physical health improvement related to the course, age. |
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