摘要
目的评估伤椎置钉后路短节段固定治疗单节段胸腰椎爆裂性骨折的临床疗效及影像学结果。方法回顾分析2008年5月~2014年5月采用伤椎置钉后路短节段固定治疗的胸腰椎爆裂性骨折且随访资料完整者68例,其中男性51例,女性17例;年龄18~62岁。评估患者术后并发症、Oswestry功能障碍指数(ODI)、术后伤椎高度矫正率、伤椎高度矫正丢失率、术后Cobb角矫正率、Cobb角矫正丢失率。结果所有患者均获得随访,时间12~94(平均47.3)个月。共3例(4.3%)患者出现术后并发症,其中切口浅表感染1例、螺钉穿透椎弓根内侧皮质2例,无一例内固定断裂。末次随访时,ODI为19.8%~29.2%[(24.4±7.6)%]、伤椎高度矫正率为91.3%~100%[(96.8±5.9)%],伤椎高度矫正丢失率为4.1%~8.2%[(7.6±2.4)%],Cobb角矫正率为83.6%~97.2%[(86.2±4.1)%]及Cobb角矫正丢失率为2.1%~6.7%[(5.8±3.4)%]。结论采用后路短节段椎弓根螺钉治疗胸腰椎爆裂性骨折时,伤椎置钉有利于恢复和维持伤椎高度、防止后凸畸形矫正及椎体高度丢失。
Objective To analyze the clinical outcomes and radiographic results of posterior short-segment fixation system with pedicle screw fixation at the level of fracture for thoracolumbar burst fractures.Methods A total of 68 patients with complete data from May 2008 to May 2014 were included in this study.Among them 51 were males and 17 were females with age of 18-62 years.Patients were treated by posterior short-segment fixation system with fixation at the level of fracture for thoracolumbar burst fractures.The data was assessed,including operative time,blood loss,length of hospital stay,postoperative complications,Oswestry disability index（ODI）,postoperative vertebral height correction rate,corrected vertebral height loss rate,postoperative Cobb＇s angle correction rate,and Cobb＇s angle correction loss rate.Results All patients were followed up for 12-94（47.3） months.A total of three cases（4.3%） had postoperative complications,including one case of superficial infection incision,and two cases of screw penetrating of the pedicle medial cortex.No case developed implants breakage.At the last follow-up,the average ODI was 19.8%-29.2% [（24.4 ± 7.6） % ],vertebral height correction rate was 91.3%-100% [（96.8 ±5.9） % ],vertebral height loss of correction was 4.1%-8.2% [（7.6 ± 2.4） % ],Cobb＇s angle correction was83.6%-97.2% [（86.2 ± 4.1） %] and Cobb＇s angle correction loss rate was 2.1%-6.7% [（5.8 ± 3.4） %].Conclusion Posterior short-segment fixation system with pedicle screw fixation at the level of fracture for thoracolumbar burst fractures can achieve satisfactory clinical outcomes and could be effective to maintain reduction and reduce the rate of correction loss.
出处
《创伤外科杂志》
2017年第4期281-283,共3页
Journal of Traumatic Surgery
关键词
胸腰椎骨折
内固定
椎弓根
螺钉
thoracolumbar fractures
internal fixation
pedicle
screw
