摘要
[目的]探讨肌间隙入路经伤椎椎弓根植骨结合短节段跨伤椎钉棒固定治疗无神经损伤的A型胸腰段椎体骨折的疗效。[方法]对2008年6月~2014年12月收治的65例A型胸腰椎骨折采用肌间隙入路经伤椎椎弓根植骨和跨伤椎钉棒固定,其中男45例,女20例,平均年龄37.50岁(23~60岁)。记录手术时间、出血量和植骨量,并对术前、术后的伤椎椎体前缘高度百分比、Cobb角、VAS评分行统计学分析。[结果]平均手术时间(97.30±13.60)min,平均术中出血量(135.30±43.50)ml,平均经椎弓根植骨量(7.50±2.10)g。全部病例均获得随访,平均随访18.20个月(12~26个月)。伤椎椎体前缘高度百分比由术前的(57.30±3.80)%恢复至术后的(90.20±6.70)%,Cobb角由术前的(24.50±2.30)°恢复至术后的(4.80±0.60)°,VAS评分由术前的(7.80±1.30)分降至术后的(1.50±0.30)分。术后和术前比较差异有统计学意义(P<0.05)。随访期间未发现内固定松动或断裂病例。[结论]肌间隙入路经伤椎椎弓根植骨联合跨伤椎钉棒固定治疗A型胸腰段椎体骨折,能有效纠正后凸畸形及保留脊柱后方软组织,是一种创伤小、术后并发症少的手术方法。
[Objective] To explore the clinical outcome of transpedicular bone grafting at the injured vertebra combined with pediele screw-rod fixation spanning the injured vertebra via the Wiltse paraspinal approach for the treatment of type A tho- raeolumbar fractures without neurological deficits. [Method] From June 2008 to December 2014, 65 patients with type A tho- raeolumbar fractures underwent the aforesaid surgical procedures, included 45 males and 20 females with an average age of 37.5 years （range, 23-60 years） . Operating time, blood loss and the weight of grafting bone were recorded. Anterior vertebral body height ratios, Cobb＇s angles and VAS scores were compared preoperatively and postoperatively. [Result] The surgical procedures lasted （97.3±13.6） min in average, with a mean blood loss of （135.3±43.5） ml and a mean graft bone weight of （7.5±2.1） g. All of the patients were followed up for an average of 18.2 months （range, 12-26 months） . The height ratio of anterior border significantly increased from （57.3±3.8） % preoperatively to （90.2±6.7） % at the latest follow up （P〈 0.001） . In addition, the Cobb＇s angle ofkyphosis significantly decreased from （24.5±2.3） ° to （4,8±0.6） ° （P〈0.001） , and the VAS score also remarkably declined from （7.8± 1.3） to （1.5±0.3） （P 〈 0.001 ） . No loosening or breakage of the internal fixation was noted in any patient. [Conclusion] Transpedieular bone grafting combined with pedicle screw-rod fixa- tion via the Wiltse paraspinal approach not only provides effective correction of kyphotie deformity, but also preserves the integ- rity of posterior soft tissue, which has advantages of minimally invasion, less blood loss and less post-operative complications.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第14期1254-1257,共4页
Orthopedic Journal of China
关键词
胸腰椎骨折
肌间隙入路
椎弓根内固定
植骨
thoracolumbar fracture, Wiltse paraspinal approach, pedicle screw-rod fixation, bone grafting
