摘要
目的：探讨Sextent经皮椎弓根螺钉治疗胸腰椎骨折的临床效果。方法2009年10月至2012年4月，应用Sextent经皮椎弓根螺钉技术治疗胸腰椎骨折10例，男8例，女2例；年龄21～51岁，平均39.2岁。其中单纯行跨伤椎4四枚螺钉6例，伤椎的上下椎及伤椎同时固定2例，跨伤椎固定联合伤椎植骨2例。所有患者术前行X线、CT、MR检查，术后即刻、术后1年、末次随访行X线、CT检查，评估其手术治疗效果。结果10例患者术后1年及末次随访的临床疗效满意，优良率100％（优7例，良3例）。术后即刻、术后1年及末次随访的载荷分享评分、伤椎前缘高度百分比、伤椎后凸Cobb＇s角和椎管堵塞指数等结果均显著优于术前。结论 Sextent系统针对不同胸腰椎骨折应强调个体化，根据不同分型和载荷评分选用不同的治疗方法，避免椎体前高、后凸角的矫正及丢失，所有患者在全麻下应首先行手法复位。采用Sextent经皮椎弓根螺钉治疗胸腰椎骨折能获得较好的临床效果。
Objective To study the clinical effect of thoracic and lumbar vertebrae fractures treated by Sextent percutaneous pedicle screw. Methods From October 2009 to April 2012, 10 patients with thoracic and lumbar vertebrae fractures were treated using the method of Sextent Per-cutaneous pedicle screw, in which 8 males and 2 females, aged from 21 to 65 years, with an average of 39.2 years. 6 cases were fixed with four screw crossed the injured vertebrae simplely. 2 cases were fixed the segments including the injured vertebrae and upward and downward of the fractured vertebral bodies. Two cases were fixed with injured vertebrae combined with vertebal bone graft. In order to evaluate the clinical effect, all the patients were assayed by X-ray, CT and MRI before operation and were then assayed by X-ray and CT immediately, one year and at final follow-up after oper-ation, respectively. Results All patients achieved satisfactory clinical results at one year after operation, the good-to-excellent rate was 100% （7 cases of excellent and 3 cases of good）. The results of load sharing scores, percentage of anterior vertebral height, Cobbs angle and the occupation in-dex of vertebral canal after operation were better than those before operation. Conclusion Individuation should be emphsized on the treatment of different types of thoracic and lumbar vertebrae fractures when using Sextent systems, according to the different subgroups and load sharing scores. The loss of vertebral height and Cobbs angle should be avoided. Manipulative reduction should be preferential under the general anesthesia. Satisfac-tory clinical results of thoracic and lumbar vertebrae fractures could be achieved by treating with Sextent Percutaneous pedicle screw.
出处
《浙江创伤外科》
2014年第6期894-898,共5页
Zhejiang Journal of Traumatic Surgery
