本文選題：胸腰椎　切入點(diǎn)：爆裂骨折　出處：《山東中醫(yī)藥大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:觀察后路短節(jié)段椎弓根內(nèi)固定系統(tǒng)治療胸腰段爆裂骨折的療效,對(duì)其進(jìn)行科學(xué)評(píng)價(jià),并探討影響預(yù)后的相關(guān)因素,為臨床提供理論依據(jù),尋找療效更佳的治療方案。方法:本研究以Frankel分級(jí)評(píng)分、VAS評(píng)分、Denis疼痛分級(jí)評(píng)估等為觀察指標(biāo),結(jié)合術(shù)前、術(shù)后的影像學(xué)(X光片、CT、MRI)表現(xiàn),對(duì)92例胸腰段爆裂骨折經(jīng)后路椎弓根內(nèi)固定系統(tǒng)治療的病例,根據(jù)患者術(shù)前、術(shù)后1周及隨訪(fǎng)末期(全部患者術(shù)后隨訪(fǎng)6~12個(gè)月,平均隨訪(fǎng)9士3.2個(gè)月)結(jié)果,進(jìn)行療效分析與評(píng)價(jià),并探討影響其療效的因素。結(jié)果:1、92例患者均在術(shù)后3~8周下床活動(dòng),未見(jiàn)內(nèi)置物的松動(dòng)、斷裂,無(wú)椎體明顯再壓縮等。2、92例病人術(shù)后疼痛明顯緩解(VAS評(píng)分和Denis疼痛分級(jí)改善),傷椎椎體高度恢復(fù)并維持良好,Cobb角以及椎體前緣高度的恢復(fù)情況較術(shù)前明顯增高(P0.05),有統(tǒng)計(jì)學(xué)意義。3、通過(guò)多元分析,得出末次隨訪(fǎng)時(shí)影響患者ODI分值的相關(guān)因素為術(shù)前椎體壓縮率、術(shù)后椎體壓縮率和疼痛狀況分級(jí)、年齡、骨質(zhì)疏松。結(jié)論:1、后路短節(jié)段椎弓根內(nèi)固定系統(tǒng)在不加大創(chuàng)傷的基礎(chǔ)上,能顯著恢復(fù)傷椎椎體高度,增加脊柱前中柱的抗壓穩(wěn)定性,使病人較早活動(dòng),有效防止術(shù)后矯正度丟失及椎體再塌陷的發(fā)生,隨訪(fǎng)療效滿(mǎn)意。2、影響其療效的主要因素是術(shù)前術(shù)后椎體壓縮率、患者腰背疼痛分級(jí)、術(shù)前骨質(zhì)疏松的程度,術(shù)前術(shù)后椎體壓縮率愈大療效越愈,骨質(zhì)疏松愈厲害預(yù)后愈差,年齡愈大療效愈差,但與性別無(wú)明顯關(guān)系。
[Abstract]:Objective: to observe the curative effect of posterior short segmental pedicle fixation system in the treatment of thoracolumbar burst fracture, to evaluate it scientifically, and to explore the related factors affecting prognosis, and to provide theoretical basis for clinical practice. Methods: in this study, Frankel grade and Frankel score and Denis pain grade were used as the observation index, combined with preoperative and postoperative CT imaging findings. 92 cases of thoracolumbar burst fracture treated by posterior pedicle internal fixation system were analyzed according to the results of preoperative, postoperative 1 week and the end of follow-up (all patients were followed up for 6 ~ 12 months on average 9 鹵3.2 months). Analysis and evaluation of the curative effect were carried out, and the factors affecting the curative effect were discussed. Results 92 patients with 1 / 92 cases got out of bed 3 weeks after operation without loosening and breaking of the implant. In 92 patients without obvious recompression of vertebral body, the pain was significantly relieved after operation, and the scores of Denis and VAS were improved. The recovery of vertebral height of injured vertebrae was better than that of preoperation. The recovery of vertebral height and anterior height of vertebral body was significantly higher than that before operation (P 0.05). Statistical significance. 3, through multivariate analysis, The factors related to the ODI score of the patients at the last follow-up were vertebral compression ratio before operation, vertebral compression rate after operation and pain status classification, age, age, and age. Conclusion: the posterior short segment pedicle internal fixation system can significantly restore the vertebral body height of the injured vertebrae, increase the stability of the anterior and middle column of the spine, and make the patient move earlier. It was effective to prevent the loss of correction degree and the occurrence of vertebral recollapse after operation. The follow-up results were satisfactory. The main factors affecting the curative effect were the rate of vertebral compression before and after operation, the grade of pain in the patients' back and back, the degree of osteoporosis before operation, and the degree of osteoporosis before operation. The greater the effect of vertebral compression ratio before and after operation, the worse the prognosis of osteoporosis and the worse the effect of age, but there was no significant relationship between the effect and sex.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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本文編號(hào)：1556483