摘要
目的探讨采用经一侧伤椎椎弓根固定(3椎5钉法),经另一侧伤椎椎弓根椎体植骨治疗胸腰椎爆裂骨折的临床疗效。方法采用后路短节段经伤椎一侧椎弓根钉复位固定,经另一侧椎弓根伤椎植入人工骨治疗胸腰椎轻中度爆裂骨折37例,根据术前及术后10 d、6个月、1年的临床表现及影像学资料,采用胸腰背痛的视觉模拟疼痛评分(VAS)、伤椎后凸Cobb角平均值、伤椎前缘平均高度比值、平均椎管占位率及神经功能恢复情况进行比较分析。结果所有患者均获得12～24个月随访,采用该方法治疗的37例患者,术后VAS评分、伤椎后凸Cobb角平均值、伤椎前缘平均高度比值、平均椎管占位率与术前比较差异均有统计学意义(P<0.05),术后神经功能亦有明显改善,无一例发生内固定失败。结论采用后路短节段经伤椎一侧椎弓根钉复位固定(3椎5钉法),经另一侧椎弓根伤椎植入人工骨治疗胸腰椎轻中度爆裂骨折可有效矫正胸腰椎后凸畸形,预防术后伤椎椎体塌陷及内固定失败,临床疗效好,是一种理想的治疗方法,值得推广。
Objective To investigate the clinical effect of pedicle screw fixation by one side of the injured vertebra（ vertebra 3 nailing 5） , and the other side of the injured vertebral body and vertebral pedicie by bony graft on tboracolambar burst fracture. Methods Thirty-seven cases of mild or moderate thoracolumbar burst fracture were treated by short-segment posterior vertebral pedicle screw fixation on one side, and vertebral pedicle bony graft on the other side. According to the clinical manifestations and imaging data before and 10 days, six months, 1 year after surgery, the thoracic back pain visual analog pain score （VAS）, the average vertebral kyphosis Cobb angle, the average anterior vertebral height ratio, the average occupancy rate of spinal canal and neurological recovery were compared. Results All of the 37 cases were followed up for 12 -24 months, there were significant differences in the visual, analog pain score （VAS）, the average vertebral kyphosis Cobb angle, the average anterior vertebral height ratio, the average occupancy rate of spinal canal before and after surgery （ P 〈 0. 05 ）, and neurological recovery was also significantly improved, no case of failure of internal fixation. Conclusions Pedicle screw fixation for one side of the injured ver- tebra （vertebra 3 nailing 5 ） and the other side of the injured vertebral body and vertebral pedicle by bony graft in treatment thora- columbar burst fracture can effectively correcte thoracolumbar kyphosis, and prevent postoperative vertebral collapse and the failure of internal fixation, with good clinical efficacy, is an ideal treatment, so is worthy of promotion.
出处
《临床医学》
CAS
2012年第11期7-10,共4页
Clinical Medicine
关键词
脊柱骨折
经伤椎固定
植骨
Spinal fractures
Fracture vertebral fixation
Bony graft
