摘要
目的探讨短节段椎弓根钉内固定对胸腰段脊柱爆裂骨折患者椎管形态及神经功能的影响。方法收集2011年1月至2016年1月梅州市人民医院采用短节段椎弓根钉内固定治疗的41例胸腰段脊柱爆裂骨折患者的临床资料,观察手术前后患者椎管形态等影像学指标、神经功能以及SF-36生活质量量表评分的变化情况。结果随访时间12~50个月,平均随访时间21个月。术后1年患者椎体后缘骨块突入椎管人数占比为15%(6/41),椎管占位百分率为(1.6±0.3)%,均显著低于术前的80%(33/41)和(34.8±6.3)%,手术前后比较,差异有统计学意义(P<0.05);患者术后Cobb角、椎体前缘及后缘高度均明显优于术前(P<0.05);神经功能方面,术后1年患者Frankel分级较术前明显改善(P<0.05);SF-36量表生理功能、生理职能、躯体疼痛、社会功能、精力、情感职能、精神健康及总体健康评分均显著高于术前(P<0.05)。术后发生椎弓根螺钉断裂1例,无神经血管损伤并发症发生。结论短节段椎弓根钉内固定可有效改善胸腰段脊柱爆裂骨折患者的椎管形态,减轻脊柱侧弯程度,恢复椎体前后缘高度,促进神经功能恢复,提高生活质量,短期疗效显著。
Objeetive To study the effects of short-segment pedicle screw internal fixation on vertebral canal morphology and nerve function of patients with thoracolumbar burst fracture. Methods Clinical data of 41 patients with thoracolumbar burst fracture treated by short-segment pedicle fixation from January 2011 to January 2016 in Meizhou People＇s Hospital were collected. Changes of radiological parameters including canal morphology, nerve function and health-related quality of life （measured by SF-36） between preoperation and postoperation were observed. Results The patients were followed up for an average time of 21 months （12-50 months）. At 1 year after the operation, the proportion of cases of vertebral posterior margin block into vertebral canal, percentage of spinal canal placeholder was 15% （6/41）, （1.6 ± 0.3） % respectively, significantly lower than preoperative 80% （33/41） and （34.8 ± 6.3）%, the differences were statistically significant （P 〈0.05）; Cobb angle, the heights of vertebral anterior and posterior edge were also improved compared to preoperative ones （P 〈0.05）. As for nerve function, Frankel grading were also improved compared to preoperative results （P 〈0.05）; SF-36 scores of physiological function, physical role, bodily pain, social function, energy, emotional function, mental health and general health were significantly higher than those preoperative ones, there were statistically significant differences （P 〈0.05）. There was 1 case with breakage of pedicle screw after the surgery, no neural or vascular injuries were found. Conclusion For patients with thoracolumbar burst fracture, short-segment pedicle screw internal fixation could obtain good short-term curative effects, in which could effectively improve vertebral canal morphology, alleviate lateral curvature, restore the heights of anterior and posterior vertebral edge, promote the recovery of nerve function, and improve quality of life of the patients.
出处
《中国骨科临床与基础研究杂志》
2017年第3期162-166,共5页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
胸椎
腰椎
脊柱骨折
骨折固定术
内
椎弓根螺钉
椎管
神经功能
Thoracic vertebrae
Lumbar vertebrae
Spine fractures
Fracture fixation, internal
Pediclescrew
Spinal canal
Nerve function
