【摘要】：[目的]探討后路不同內(nèi)固定方式治療胸腰椎爆裂性骨折的臨床療效。[方法]2009年2月~2015年7月對116例胸腰椎爆裂性骨折患者行后路復(fù)位固定手術(shù)治療,按手術(shù)方式將患者分為三組,38例采用傷椎椎弓根內(nèi)置短螺釘(傷椎短釘組),38例采用傷椎椎弓根內(nèi)置長螺釘(傷椎長釘組),40例后路短節(jié)段椎弓根釘內(nèi)固定傷椎不置螺釘(傷椎無釘組)。[結(jié)果]隨訪9~36個月,平均15.8個月。三組手術(shù)前后傷椎前緣高度比、脊柱后凸Cobb角、傷椎椎管矢狀徑和橫截面積比較均有明顯改善,差異有統(tǒng)計學(xué)意義(P0.01)。術(shù)后神經(jīng)功能狀態(tài)較術(shù)前有顯著改善,差異有統(tǒng)計學(xué)意義(P0.05)。傷椎短釘組、傷椎無釘組在術(shù)后矯正率、術(shù)后椎管面積改善率,優(yōu)于傷椎長釘組,組間比較差異有統(tǒng)計學(xué)意義(P0.05)。傷椎短釘組和傷椎長釘組的遠(yuǎn)期矯正丟失率和內(nèi)固定失效率均低于傷椎無釘組(P0.05)。三組間神經(jīng)功能恢復(fù)比較差異無統(tǒng)計學(xué)意義(P0.05)。術(shù)后疼痛評分傷椎短釘組優(yōu)于傷椎長釘組和傷椎無釘組(P0.05)。術(shù)后并發(fā)癥三組無顯著差別。[結(jié)論]在后路內(nèi)固定中增加經(jīng)傷椎椎弓根內(nèi)置短螺釘內(nèi)固定是治療胸腰椎爆裂性骨折的更有效手段。
[Abstract]:[objective] to investigate the clinical effect of posterior internal fixation for thoracolumbar burst fracture. [methods] from February 2009 to July 2015, 116 patients with thoracolumbar burst fracture were treated by posterior reduction and fixation. According to the operation mode, the patients were divided into three groups. 38 cases were treated with pedicle internal short screw (short screw group). 38 cases were treated with long screw in pedicle of injured vertebrae (long screw group) and 40 cases with internal fixation of short segment pedicle screw in posterior approach (no screw group). [results] Follow-up for 9 ~ 36 months (mean 15.8 months). The anterior height ratio, Cobb angle of scoliosis, sagittal diameter and cross-sectional area of injured vertebral canal were significantly improved in the three groups before and after operation (P0.01). Postoperative neurological function was significantly improved compared with preoperative, the difference was statistically significant (P0.05). The rate of postoperative correction and the improvement rate of postoperative spinal canal area in the short nail group and the non-nail group were better than those in the long nail group. The difference between the two groups was statistically significant (P0.05). The long-term correction loss rate and the internal fixation failure rate of the short nail group and the long screw group were lower than those of the non-nail group (P0.05). There was no significant difference in the recovery of nerve function among the three groups (P0.05). Postoperative pain score of short nail group was better than that of long nail group and no nail group (P0.05). There was no significant difference in postoperative complications among the three groups. [conclusion] it is a more effective method to treat thoracolumbar burst fracture by adding internal fixation of pedicle of injured vertebrae in posterior internal fixation.
【作者單位】： 山東巨野縣人民醫(yī)院骨三科;青島市立醫(yī)院脊柱外科;
【分類號】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 ;全軍骨折內(nèi)固定與人工關(guān)節(jié)置換技術(shù)學(xué)習(xí)班在泰安圓滿結(jié)束[J];中國矯形外科雜志;2000年12期

2 劉鋒,范衛(wèi)民,陶松年;60歲以下股骨頸頭下型骨折50例內(nèi)固定治療分析[J];南京醫(yī)科大學(xué)學(xué)報;2001年02期

3 黃宏嶇;;老年股骨粗隆間骨折微創(chuàng)內(nèi)固定與開放內(nèi)固定手術(shù)的對比研究[J];中國醫(yī)藥指南;2012年36期

4 蔡梅生，劉旭君，羅鐵夫，孟兵，張毅夫，丁珂，，龔興華;開放性脛腓骨骨折內(nèi)固定治療156例報告[J];湖南醫(yī)學(xué);1994年S1期

5 嚴(yán)清;老年股骨粗隆間骨折采用三種內(nèi)固定方法的體會[J];中國矯形外科雜志;1999年06期

6 呂漢棠;腓骨內(nèi)固定治療重度開放性脛腓骨骨折38例[J];中華創(chuàng)傷雜志;2000年04期

7 徐德義,李云學(xué);內(nèi)固定治療肩胛骨骨折3例[J];中國骨傷;2000年06期

8 趙友明;單側(cè)多功能外固定支架與內(nèi)固定聯(lián)合治療開放性粉碎性脛腓骨骨折[J];中國骨傷;2000年08期

9 陳秀民,丁敬沛,王在斌,李百華;經(jīng)皮鋼針內(nèi)固定治療兒童肱骨髁上骨折[J];中醫(yī)正骨;2000年02期

10 那朝陽;內(nèi)固定治療開放性脛腓骨骨折46例[J];包頭醫(yī)學(xué)院學(xué)報;2001年04期

相關(guān)會議論文 前10條

1 申玉才;;脛腓骨開放性骨折的內(nèi)固定治療[A];第七屆全國創(chuàng)傷學(xué)術(shù)會議暨2009海峽兩岸創(chuàng)傷醫(yī)學(xué)論壇論文匯編[C];2009年

2 周鑫建;黃偉杰;;DHS內(nèi)固定治療老年股骨粗隆間骨折臨床療效分析[A];第七屆全國創(chuàng)傷學(xué)術(shù)會議暨2009海峽兩岸創(chuàng)傷醫(yī)學(xué)論壇論文匯編[C];2009年

3 牟傳勇;周長明;王國華;辛兵;李榮俊;;老年股骨粗隆間粉碎性骨折內(nèi)固定術(shù)后失敗再治療方法探討[A];第十六屆全國中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會暨中西醫(yī)結(jié)合手法治療骨傷科疾病新進(jìn)展學(xué)習(xí)班論文匯編[C];2008年

4 胡p

本文編號：2424110