本文選題：胸腰椎骨折 + 短節(jié)段內(nèi)固定　； 參考：《中國脊柱脊髓雜志》2016年12期

【摘要】：目的 :探討后路經(jīng)傷椎與跨傷椎椎弓根螺釘內(nèi)固定對胸腰椎骨折椎體中央高度恢復(fù)的影響及其臨床意義。方法:回顧性分析我院2011年1月~2012年12月收治的胸腰椎骨折病例67例,其中男36例,女31例,年齡17~52歲,平均37.8±7.5歲。所有患者為T11~L2單椎體骨折(AO分型為A型),且無嚴(yán)重的神經(jīng)脊髓癥狀(ASIA分級為D、E級)。均采用后路短節(jié)段椎弓根螺釘內(nèi)固定術(shù)式,按固定方式不同分為經(jīng)傷椎固定組(A組,n=37)、跨傷椎固定組(B組,n=30)。在PACS圖像系統(tǒng)上測量X線側(cè)位片傷椎椎體前緣高度(Ha)、椎體中央高度(Hm)、椎體后緣高度(Hp)及后凸Cobb角,計算Ha壓縮率、Hm壓縮率,比較術(shù)前、術(shù)后1周、末次隨訪時Ha壓縮率、Hm壓縮率及Cobb角,觀察術(shù)后骨折椎體中央高度恢復(fù)的情況。結(jié)果:所有患者獲得18~40個月的隨訪,平均隨訪時間26.5±8.9個月。無論經(jīng)傷椎固定還是跨傷椎固定,術(shù)后Ha壓縮率、Hm壓縮率及Cobb角均較術(shù)前有顯著減少(P0.05),其中A組患者Hm壓縮率術(shù)前為(44.8±10.3)%,術(shù)后1周時為(31.6±7.1)%,末次隨訪時為(31.3±6.8)%。B組患者Hm壓縮率術(shù)前為(38.6±8.3)%,術(shù)后1周時為(32.0±8.4)%,末次隨訪時為(31.7±8.6)%。A、B兩組患者術(shù)后椎體中央高度均有約30%的壓縮殘留。結(jié)論 :經(jīng)傷椎和跨傷椎椎弓根螺釘內(nèi)固定治療胸腰椎骨折均可促進(jìn)骨折椎體前緣及中央高度的恢復(fù),改善節(jié)段后凸角度,但術(shù)后傷椎椎體中央高度有明顯壓縮殘留。
[Abstract]:Objective: to investigate the effect of posterior pedicle screw fixation on the recovery of vertebral body height in thoracolumbar fractures and its clinical significance. Methods: from January 2011 to December 2012, 67 cases of thoracolumbar fractures were retrospectively analyzed, including 36 males and 31 females, with an average age of 37.8 鹵7.5 years. All patients were T11L2 single vertebral body fracture (AO type A) and no severe neurological and spinal cord symptoms (Asia grade was DNE grade). All patients were treated with posterior short segment pedicle screw fixation and were divided into two groups: group A (group A) and group B (group B). The anterior height (Ha), central height (H m), posterior edge height (HP) and kyphosis angle of vertebral body were measured on PACS imaging system. At the last follow-up, Ha compression ratio, H m compression rate and Cobb angle were observed to observe the recovery of fracture vertebral central height. Results: all the patients were followed up for 18 ~ 40 months with an average follow-up time of 26.5 鹵8.9 months. Whether the injured vertebra is fixed or the cross-injured vertebra is fixed, The ratio of H _ m compression and Cobb angle in group A was (44.8 鹵10.3) before operation, (31.6 鹵7.1) at 1 week after operation, (31.3 鹵6.8) in group B, (38.6 鹵8.3) before operation, (32.0 鹵8.4) at 1 week after operation, and (32.0 鹵8.4) at 1 week after operation. At the follow-up time (31.7 鹵8.6), there was about 30% compression residue in the central height of the vertebral body after operation in the two groups (31.7 鹵8.6). Conclusion: the treatment of thoracolumbar fractures with transpedicular screw fixation can promote the recovery of anterior and central height of the fracture and improve the angle of segmental kyphosis, but the central height of the injured vertebral body is significantly compressed and residual after operation.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院脊柱骨科;
【分類號】：R687.3

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本文編號：2088848