【摘要】：[目的]分析預(yù)彎棒在預(yù)防胸腰椎骨折前路手術(shù)后脊柱出現(xiàn)側(cè)方成角的效果。[方法]回顧性分析2010年9月~2015年6月本院胸腰椎骨折前路手術(shù)患者共218例,其中影像學(xué)資料完整的208例。評估每一位患者的影像資料,測量椎體螺釘與終板的夾角,208例中男139例,女69例,年齡16~68歲,平均(38.1±14.9)歲。損傷類型:車禍31例,重物砸傷23例,高處墜落傷154例。骨折椎體節(jié)段:T_(11)2例,T_(12)18例,L_1137例,L_241例,L_39例,L_41例;骨折椎體AO分型:A型194例,B型14例;脊髓損傷Frankel分級:A級53例,B級11例,C級35例,D級39例,E級70例。內(nèi)固定材料:Antares(美敦力公司)197例和Z-Plate(美敦力公司)11例。208例中有20例術(shù)中通過預(yù)彎連接棒預(yù)防可能形成的側(cè)方成角,20例中男14例,女6例,年齡28~53歲,平均(35.3±20.1)歲。損傷類型:車禍6例,重物砸傷1例,高處墜落13例。骨折椎體節(jié)段:T_(11)0例,T_(12)1例,L_115例,L_23例,L_31例;骨折椎體AO分型:A型20例;脊髓損傷Frankel分級:A級5例,B級1例,C級3例,D級4例,E級7例。內(nèi)固定材料:全部應(yīng)用Antares脊柱前路內(nèi)固定系統(tǒng)(美敦力公司)。[結(jié)果]全部病例中有9例術(shù)后出現(xiàn)超過5°以上的側(cè)方成角,沒有10°以上的側(cè)方成角。術(shù)前側(cè)方成角平均1.31°±4.09°,術(shù)后側(cè)方成角平均2.19°±3.78°,術(shù)前與術(shù)后冠狀面Cobb角比較差異無統(tǒng)計(jì)學(xué)意義。20例應(yīng)用預(yù)彎棒的患者術(shù)中均出現(xiàn)椎體螺釘與相應(yīng)的終板較大的成角,但術(shù)后均沒有出現(xiàn)超過5°以上的側(cè)方成角。術(shù)前側(cè)方成角平均2.11°±4.26°,術(shù)后側(cè)方成角平均2.31°±3.58°,術(shù)前與術(shù)后冠狀面Cobb角比較差異無統(tǒng)計(jì)學(xué)意義。[結(jié)論]預(yù)彎棒可以有效地預(yù)防胸腰椎骨折前路手術(shù)術(shù)后脊柱側(cè)方成角的發(fā)生。
[Abstract]:Objective: to analyze the effect of prebending bar in preventing lateral angulation of spinal column after thoracolumbar fracture. [methods] 218 patients with thoracolumbar fractures were analyzed retrospectively from September 2010 to June 2015, including 208 cases with complete imaging data. The imaging data of each patient were evaluated and the angle between vertebral screw and endplate was measured. There were 139 males and 69 females with a mean age of (38.1 鹵14.9) years. Injury type: 31 cases of traffic accident, 23 cases of heavy object injury, 154 cases of falling injury. There were 2 cases of T _ (11), 18 cases of T _ (12), 1137 cases of L _ s, 241 cases of L _ s, 39 cases of L _ s, 41 cases of L _ S, AO classification of fracture vertebral body: type A 194 cases, B type 14 cases; Frankel classification of spinal cord injury: 53 cases of grade A, 11 cases of grade B, 35 cases of grade C, 39 cases of grade D and 70 cases of grade E. There were 197 cases of internal fixation material: Antares (Medtronic Company and 11 cases of Z-Plate. 20 of 208 cases were prevented from forming lateral angle by prebending connecting rod during operation, of which 14 cases were males and 6 cases were females, aged 2853 years. The mean age was (35.3 鹵20.1) years. Injury type: 6 cases of traffic accident, 1 case of heavy object smashing, 13 cases of falling from height. Fracture vertebral segment: T11, T12, L115, L23, L31, AO classification: type A, type A. Frankel classification of spinal cord injury: 5 cases were grade A, 1 case was grade B, 3 cases were grade C, 4 cases were grade D, and 7 cases were grade E. Internal fixation materials: Antares anterior spinal internal fixation system (Medtronic). [results] there were more than 5 擄lateral angulation in 9 cases after operation, but no more than 10 擄lateral angulation. The mean lateral angle was 1.31 擄鹵4.09 擄before operation and 2.19 擄鹵3.78 擄after operation. There was no significant difference in Cobb angle between preoperative and postoperative coronal plane. In 20 patients with prebending rod, there were larger angles of vertebral screw and corresponding endplate during operation, but no lateral angle more than 5 擄was found after operation. The mean lateral angle was 2.11 擄鹵4.26 擄before operation and 2.31 擄鹵3.58 擄after operation. There was no significant difference in Cobb angle between preoperative and postoperative coronal plane. Conclusion: prebending bar can effectively prevent lateral angulation of thoracolumbar fractures after anterior operation.
【作者單位】： 四川大學(xué)華西醫(yī)院骨科;
【分類號】：R687.3

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