摘要
背景:椎弓根螺钉置入内固定是一种胸腰椎骨折常用的修复方式,其中经伤椎置钉是一种重要的方法,但关于其远期效果和生物力学特性还有待进一步分析。目的:分析经伤椎椎弓根螺钉置入内固定修复胸腰椎骨折的远期效果及其生物力学特性。方法:回顾性分析126例胸腰椎骨折患者的临床资料,均实施经伤椎椎弓根螺钉置入内固定修复治疗,定期随访了解患者的远期修复效果。取新鲜小牛胸腰椎标本10具,5具标本设为实验组,制备前中柱损伤骨折模型,进行经伤椎椎弓根螺钉置入内固定修复;另外5具设为对照组,不进行任何处理。对两组标本螺钉沿椎体矢状轴方向上的轴向压缩位移、前屈位移、后伸位移、扭转角度以及拔出强度进行测量,并予以记录。结果与结论:(1)临床试验结果:126例患者全部获得随访,随访时间10-36个月。较之治疗前,患者治疗后1个月和末次随访的伤椎压缩率、椎间隙高度、伤椎滑移距离、目测类比评分、Cobb’s角等指标均得到显著改善(P均<0.05);治疗后1个月与末次随访比较,差异均无显著性意义(P均>0.05)。经末次随访,患者的Frankel脊髓损伤分级情况得到了显著改善(Z=-4.127,P<0.05)。治疗后3例患者出现肺部感染,4例患者出现泌尿系统感染,1例患者出现切口延迟愈合。(2)生物力学实验结果:实验组在轴向压缩位移、前屈位移、后伸位移、扭转角度以及拔出强度方面的测量结果均小于对照组,但经比较差异均无显著性意义(P均>0.05)。(3)由以上结果可知,经伤椎椎弓根螺钉置入内固定修复胸腰椎骨折可以获得良好的远期效果,且具有良好的生物力学特性。
BACKGROUND： Pedicle screw fixation is a common repair method for thoracolumbar fractures. Of them, pedicle screw placement into the injured vertebra is an important method. However, the long-term effects and the related biomechanical properties deserve further analysis. OBJECTIVE： To analyze the long-term effect and biomechanical characteristics of the internal fixation of thoracolumbar fractures by pedicle screw implantation. METHODS： A retrospective analysis was performed in 126 cases of thoracolumbar fractures. The patients were treated with pedicle screw implantation and the treatment was followed up regularly. Ten specimens of fresh calf chest and lumbar spines were obtained. Five specimens served as an experimental group to prepare models of anterior middle column fractures, and these specimens received pedicle screw fixation into the injured vertebra. The other five specimens served as the control group, and did not receive any treatment. In the two groups, along the sagittal axis, axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pull-out strength were measured and recorded. RESULTS AND CONCLUSION：（1） Clinical trial results： 126 patients were followed up for 10-36 months. Compared with pre-treatment, compression ratio of the injured vertebra, the height of intervertebral space, vertebral slip distance, visual analogue score and Cobb angle were significantly improved at 1 month after treatment and during final follow-up（all P〈0.05）. No significant difference in above indexed was detected between 1 month and final follow-up（all P〉0.05）. At the end of follow-up, Frankel spinal cord injury grade was significantly improved（Z=-4.127, P〈0.05）. After operation, three patients suffered from pulmonary infection, four patients affected urinary tract infection, and one patient experienced delayed wound healing.（2） Biomechanical results： axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pull-out strength were smaller in the experimental group than in the control group（all P〉0.05）.（3） Above findings showed that pedicle screw fixation into the injured vertebra for thoracolumbar fractures obtained good long-term effects, and had good biomechanical properties.
出处
《中国组织工程研究》
CAS
北大核心
2016年第4期571-576,共6页
Chinese Journal of Tissue Engineering Research
基金
河源市科技项目(2012-023)"改良经伤椎置钉椎弓根钉系统治疗胸腰椎骨折"~~
