The Application Of Early Anterior And Posterior Cervical Spine Surgery In The Treatment Of Acute Cervical Spinal Cord Injury With Traumatic Wet Lung

Object:To evaluate the application of early anterior and posterior ervical spine surgery in the treatment of acute cervical spinal cord injury with traumatic wet lungMethod:Retrospective analysis of the Department of Spinal Surgery of the China-Japan Union Hospital of Jilin University and the Second Hospital of Jilin University from December 2012 to June 2018.The fracture and dislocation type of spinal cord injury combined with traumatic wet lung to anterior and posterior cervical spine surgery.The clinical data of patients with fixed pedicle and anterior cervical vertebral corpectomy(pre-cranial anterior discectomy)with bone graft fusion and internal fixation were divided into two groups according to the time of injury after operation: group A(48 hours after injury)Internal surgery group,group B(surgery group within 48 hours after injury),record the patient’s in-hospital complications and hospitalization days,follow-up visits or telephone follow-up,using the Japanese Orthopaedic Association for cervical spinal cord function assessment criteria Methods(JOA 17)were used to evaluate neurological function.The ASIA score was used to evaluate the motor function of patients after admission and six monthsafter surgery.The patient’s preoperative and postoperative pulmonary function indicators were compared.Results:In this study,all the 12 patients with anterior and posterior ervical spine surgery.The JOA scores of patients with A and B were improved compared with those before operation.After re-examination and follow-up,all patients had no internal fixation loose and well fused.There were no serious complications during the hospitalization of the two groups.One patient developed pulmonary infection in group A and two patients developed pulmonary infection in group B.The complications were cured after being referred to the relevant department for consultation and symptomatic treatment.There was no significant difference in preoperative JOA scores between the two groups(P>0.05).There was a statistically significant difference in JOA scores between the two groups(P<0.05),and the difference in JOA improvement in the three months after surgery.Statistical significance(P>0.05),the difference of JOA improvement between the six months after operation was statistically significant(P<0.05).The improvement of JOA score before and after surgery was better than that of group B.The average length of hospital stay was The difference was statistically significant(P<0.05).The hospitalization days of patients in group A were less than those in group B.The preoperative Pa O2 and Pa CO2 parameters were not significantly different.Thedifference of Pa O2 and Pa CO2 between the two groups was postoperative.<0.05,statistically significant.Pa O2 and Pa CO2 in group A were significantly better than those in group B(P<0.05).Conclusion:Fracture and dislocation type cervical spinal cord injury combined with traumatic wet lung in the early 48 hours of anterior and posterior cervical spine surgery can more effectively reduce the joint biochemical malignant injury after cervical spinal cord injury,make the residual nerve function plasticity recovery,promote Benign transformation of neurological function.At the same time,the lung function is assisted by mechanical ventilator and decompression of cervical spinal cord injury,and the effective treatment and control progress and mortality are reduced.