發(fā)布時(shí)間：2018-03-19 18:27

  本文選題：脊柱骨折　切入點(diǎn)：胸椎　出處：《中醫(yī)正骨》2016年11期 　論文類型：期刊論文

【摘要】：目的:觀察小開窗減壓短力臂傷椎置釘復(fù)位內(nèi)固定術(shù)治療胸腰椎爆裂性骨折的臨床療效和安全性。方法:2010年1月至2015年1月,采用小開窗減壓短力臂傷椎置釘復(fù)位內(nèi)固定術(shù)治療胸腰椎爆裂性骨折患者38例,男24例、女14例。年齡20~63歲,中位數(shù)43歲。損傷椎體,T_(10)2例、T_(11)6例、T_(12)14例、L_110例、L_26例。按脊髓損傷的Frankel分級(jí),A級(jí)3例、B級(jí)4例、C級(jí)14例、D級(jí)10例、E級(jí)7例。傷后至手術(shù)時(shí)間1~16 d,中位數(shù)4 d。術(shù)后隨訪觀察骨折愈合、椎體高度恢復(fù)、后凸畸形矯正、脊髓神經(jīng)功能恢復(fù)及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲隨訪,隨訪時(shí)間12~24個(gè)月,中位數(shù)16個(gè)月。骨折均獲骨性愈合。術(shù)后1周與術(shù)后12個(gè)月傷椎椎體高度丟失率[(傷椎相鄰上下椎體高度的平均值-傷椎椎體高度)"傷椎相鄰上下椎體高度的平均值×100%)]分別由術(shù)前(44.83±12.73)%降低至(10.24±7.25)%、(13.11±8.51)%,Cobb角由術(shù)前31.49°±14.17°降低至6.90°±5.15°、8.74°±6.39°。術(shù)后12個(gè)月,部分病例的脊髓神經(jīng)功能有所恢復(fù);按脊髓損傷的Frankel分級(jí),A級(jí)3例、B級(jí)1例、C級(jí)2例、D級(jí)12例、E級(jí)20例。均無內(nèi)固定斷裂、松動(dòng)等并發(fā)癥發(fā)生。結(jié)論:采用小開窗減壓短力臂傷椎置釘復(fù)位內(nèi)固定術(shù)治療胸腰椎爆裂性骨折,創(chuàng)傷小,能促進(jìn)骨折愈合,恢復(fù)椎體高度,糾正后凸畸形,有利于脊髓神經(jīng)功能的恢復(fù),且并發(fā)癥少,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical efficacy and safety of small fenestration, decompression, short arm injury, reduction and internal fixation for thoracolumbar burst fracture. Methods: from January 2010 to January 2015, the treatment of thoracolumbar burst fracture was performed. 38 patients (24 males and 14 females) with thoracolumbar burst fracture were treated with small fenestration, decompression, short arm injury, reduction and internal fixation. The median was 43 years old. There were 116 cases of Tastoma and 116 cases of Tastoma. According to the Frankel grade of spinal cord injury, 3 cases were grade A, 4 cases were grade C, 10 cases were grade D, 7 cases were grade E. The time from injury to operation was 116 days, and the median was 4 days. The fracture healing was observed after operation, and the fracture healing was observed after operation, according to the Frankel grade of spinal cord injury, 3 cases with grade A and 14 cases with grade C and grade C, grade C and grade D, grade C and grade E in 7 cases, the operative time from injury to operation was 1 16 days, the median was 4 days. Results: all the patients were followed up for 12 ~ 24 months. Median 16 months. Bone union was achieved in all fractures. Loss rate of vertebral height at 1 week and 12 months after operation [(average of upper and lower vertebral height of injured vertebrae-height of injured vertebra) "level of height of adjacent upper and lower vertebrae of injured vertebra. The mean value of Cobb decreased from 44.83 鹵12.73% to 10.24 鹵7.25% from 44.83 鹵12.73% to 13.11 鹵8.51 擄from 31.49 擄鹵14.17 擄to 6.90 擄鹵5.15 擄8.74 擄鹵6.39 擄, respectively, 12 months after operation, the mean value of Cobb decreased from 31.49 擄鹵14.17 擄to 6.90 擄鹵5.15 擄鹵8.74 擄鹵6.39 擄. The neurological function of spinal cord recovered in some cases, according to the Frankel grade of spinal cord injury, there were 3 cases of grade A, 1 case of grade B, 2 cases of grade C, 12 cases of grade D and 20 cases of grade E, all of which had no fracture of internal fixation. Conclusion: the treatment of thoracolumbar burst fracture with small fenestration, decompression, short arm injury and reduction and internal fixation can promote fracture healing, recover vertebral body height and correct kyphosis deformity. It is beneficial to the recovery of spinal cord nerve function and has fewer complications, so it is worth popularizing in clinic.
【作者單位】： 河南省洛陽(yáng)正骨醫(yī)院/河南省骨科醫(yī)院;
【分類號(hào)】：R687.3

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