摘要
目的：评价经伤椎置椎弓根螺钉系统单节段固定治疗胸腰椎单椎体骨折可能性以及探讨伤椎置钉技术和适应证。方法：2009年1月-2013年3月，采用单节段椎弓根螺钉固定治疗胸腰椎骨折49例。通过拍摄DR片测量骨折节段Cobb角、骨折椎楔变指数评价影像学效果，脊髓损伤按ASIA分级进行临床效果评估。结果：37例患者获随访，平均随访时间为15．6个月（11～28个月），切口长度为平均6．2cm，手术时间平均50min，术中出血量平均156mL。术前骨折节段Cobb角、伤椎楔变指数分别为20．1°，41．82％；术后分别为3．98°，9．61％，最后1次随访分别为4．16°，10．04％，差异有统计学意义（P〈0．05），最后随访末见明显矫正丢失（P〉0．05）。脊髓神经功能均获得明显改善，无1例出现神经功能恶化。结论：经伤椎单节段复位固定融合术具有创伤小、用时短、出血少、伤椎椎体高度恢复好，脊椎运动功能单位丢失减小，部分年老患者可避免2次手术等优点。
To explore the possibility of injuried vertebral pedicle screw system of single segment fixation at the level of the fracture for the treatment of thoracolumbar vertebral fractures and the surgical technique and indications. Meth- ods： A total of 49 cases of thoracolumbar fractrues were treated from January 2009 to march 2013. All of them were treated with monosegmental pedicle screws fixation at the fracture level. By taking DR and measuring section Cobb angle, vertebral wedge index to evaluate radiologic results, while clinical results were evaluated according to ASIA grade of spinal cord inju- ry. Results：All cases were followed up average 15.6 months（11 - 28months）, with average length of the incision 6.2cm and average operation duration of 50 minutes and average operative blood loss of 156 ml. The Cobb angle and wedge index rate were 20. 1%and 41.82%preoperatively and 3.98%and 9.61%postoperatively, with statistical difference （P〈0. 05）. The final follow-up showed （the Cobb angle and wedge index rate were 4.16%, 10.04 %） no significant correction loss （P〉0.05）. The patients gained significant improvement in spinal cord function, no neurologic deterioration. Conclusion：The injured vertebrae monosegment reduction fixation fusion has advantages of minimal invasion, short operative duration, less blood loss, less vertebral motion segment loss and can avoid secondary operation in some oldness.
出处
《中国中医骨伤科杂志》
CAS
2014年第5期36-38,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
脊柱损伤
胸椎
腰椎
椎弓根
内固定
Spinal fracture
Lumbar vertebrae
Thoracic vertebra
Pedicle of vertebral arch
Internal fixation
