摘要
目的探讨应用伤椎置钉技术治疗合并骨质疏松症的胸腰段爆裂骨折的临床疗效。方法手术治疗36例无神经症状的单椎体合并骨质疏松症的胸腰段爆裂骨折患者,采用骨折上下椎置钉,伤椎置入椎弓根螺钉,安装连接棒,通过体位及撑开实现骨折椎体复位。应用VAS及SF-36量表评估患者疼痛及生活质量改变情况;摄X线片测量受伤节段后凸矫正率及矫正丢失率。结果患者均获随访,时间9～48个月。临床疗效:VAS评分:末次随访时2.98分±1.25分,术后2.09分±1.12分,与术前7.42分±1.05分比较,差异有统计学意义(P=0.000);SF-36评分:末次随访时122.5分±24.3分,与术前93.7分±16.5分比较,差异有统计学意义(P<0.05)。影像学评价:Cobb角术后6.5°±2.1°,与术前34.3°±7.4°比较,矫正率为81.5%±5.4%;末次随访时7.1°±4.3°,矫正丢失率为9.2%±3.6%。无内固定松动及断裂。结论应用伤椎置钉技术能够有效恢复并维持伤椎高度,减少后凸畸形矫正丢失及内固定失败的发生,具有良好的疗效。
Objective To investigate the curative effect of pedicle fixation at the level of fracture for thoracolumbar burst fractures in patients with osteoporosis. Methods The clinical data of thoracolumbar burst fractures in 36 patients with osteoporosis, single segment fracture and neurological intact were analyzed retrospectively. Pedicle screws was inserted into the injured vertebra and the height of the collapsed vertebra fractures were reduced with position and instrument. VAS and SF-36 scoring systems were used to evaluate patients＇ pain and life quality. The kyphotie correction rate and loss of correct rate of fracture level was counted by X-ray. Results All patients were followed up for 9 - 48 months. There were significant differences （ P = 0. 000） in VAS score between last follow-up 2. 98 ＋ 1.25 and postoperation 2.09 ± 1.12 with preoperation 7.42 ± 1.05, respectively. And also there was significant difference （P 〈0.05） in SF-36 score between last follow-up 122. 5±24. 3 and postoperation 93.7 ± 16. 5. The Cobb angle was corrected to 6.5° ± 2. 1° of postoperation from 34. 3°± 7.4° preoperation, and the correct rate was 81.5 % ±5.4%, 7. 1° ±4. 3°of last follow-up and the loss of correct rate was 9. 2%± 3.6%. There was no loosening or breakage of internal fixations. Conclusions Pedicle fixation at the level of fracture is a safe and effective method as it can maintain reduction as well as decreasing the rate of correction loss and internal fixation failure.
出处
《临床骨科杂志》
2013年第4期381-383,共3页
Journal of Clinical Orthopaedics
关键词
椎弓根螺钉
伤椎置钉
骨质疏松
胸腰椎骨折
爆裂性骨折
pediele screw
vertebra fracture fixation
osteoporosis
thoraeolumbar fractures
burst fracture
