摘要
目的探讨经伤椎椎弓根螺钉系统固定治疗胸腰椎骨折的临床疗效。方法收集采用椎弓根螺钉系统同时经伤椎置钉固定治疗胸腰椎单椎体骨折165例,按骨折形态分类:楔形压缩骨折95,稳定爆裂骨折44例,不稳定爆裂骨折23例,Chance骨折3例。均采用经伤椎6钉三椎体固定,同时作单节段后外侧同种异体骨植骨融合,并进行临床Denis疼痛评分、调查患者手术的满意度及X线检查情况(包括术前、术后、随访时椎体的高度、Cobb角、内固定物的状况等)。结果除2例患者失访外其他患者均得到随访,随访12～70个月,平均45.6个月;随访按照Denis疼痛分级,P1级148例患者无疼痛,P2级15例患者有轻微疼痛,无需服药治疗。所有患者均对手术表示满意。X线检查术后椎体高度恢复满意,术后伤椎矫正率为96.4%。末次随访时Cobb角由术前的11～47°(平均24.5°)矫正至-2～19°(平均6.2°);椎体前缘高度由术前丢失10%～49%(平均37.7%)恢复至正常高度的85%～100%(平均92.7%)。无内固定物断裂、松动、脱出,所有病例均获得骨性融合,无假关节形成。结论经伤椎椎弓根螺钉系统固定治疗胸腰椎骨折,伤椎复位满意,固定可靠,是一种可行而有效的方法。
Objective To explore the effective of the treatment to the thoracolumbar spine fracture by using pedicle screw fixation through the injured vertebral. Methods 165 cases were diagnosed as the thoracolumbar spine fracture, received the treatment of pedicle screw fixation through the injured vertebral. Those vertebral fracture were classified according to the fracture morphology, including of 95 wedged compression fracture ,44 stable burst fractures ,23 unstable burst fracture and 3 Chance fracture. All the cases were received the treatment of pedicle screw fixation through the injured vertebral and single segment posterior - lateral fusion with autogenous bone. Denis pain score,the patients＇ satisfaction and x - ray （including of pre - operation, post - operation, the height of vertebra, Cobb degree and the fixation situation） were analyzed. Results All the cases were followed up between 12 and 70 months （ averaged 45.6 months） ,2 cases were excepted. 148 patients had no pain at class P1,15 patients had slightly pain which did not need any drugs at class P2. The vertebral height recovered well. The injured vertebra correction rate was 96.4%. The Cobb degree was improved from 11 - 47 degree （ averaged 24.50） pre - operation to - 2 - 19 ° （ averaged 6.2° ） post - operation. The anterior edge of vertebral height losses were improve from 10% -49% （ averaged 37.5% ） pre - operation to 85% - 100% （ averaged 92.7% ）. There was no one case of internal fixation failure or bone union or pseudarthrosis. And all the patients were satisfied with the operations. Conclusion It＇s a feasible and effective way to treat the thoracolumbar spine fracture using pedicle screw fixation through the injured vertebral because of it＇s satisfied reduction and reliably fixation.
出处
《宁夏医学杂志》
CAS
2013年第5期393-395,共3页
Ningxia Medical Journal
关键词
胸腰椎骨折
椎弓根螺钉系统
伤椎
内固定
融合
Thoracolumbar spine fracture
Vertebral pedicle screw systems
Injured vertebral
Fixation
Fusion
