摘要
目的探讨经椎间孔椎体间融合术（transforaminal interbody fusion，TIF）治疗胸腰椎骨折的价值。方法2009年1月至2010年6月，应用TIF技术治疗胸腰椎骨折11例，男7例，女4例；年龄22～54岁，平均（37．8±9．5）岁。损伤节段：T111，12 22例，T12L1 5例，L1，2 2例，L2，31例，L3，4 1例。均为AO分型B型骨折。胸腰椎损伤分类及严重度评分（thoracolumbar injury classification and severity score，TLICS）为7～10分，平均（9．2±0．87）分。Frankel脊髓损伤分级B级3例，C级4例，D级3例，E级1例。术后随访时评估Frankel脊髓损伤分级改善和矢状面Cobb角矫正及维持情况。结果手术时间130～170min，平均（147．3±11．9）rain；术中出血180～650ml，平均（369．1±110.2）ml。全部获得随访，随访时间13～26个月，平均（20．2±4.3）个月。无术中及术后并发症。末次随访X线片提示内固定无松动、断裂、融合器移位等情况，骨折节段稳定。9例患者Frankel脊髓损伤分级改善。术前矢状面Cobb角-21．2°～3．2°，平均-10-3°±7．8°；末次随访时-7．9°～17．2°，平均1．2°±7．4°，Cobb角明显矫正，随访期间无明显丢失。结论应用TIF技术治疗胸腰椎骨折在畸形矫正、神经功能改善、植骨融合和内固定稳定等方面具有良好效果。
Objective To explore effect of transforaminal interbody fhsion （TIF） in the treatment of thoracolumbar fracture. Methods From January 2009 to June 2010, 11 patients with thoracolumbar fracture underwent TIF in our hospital. There were 7 males and 4 females, aged from 22 to 54 years （average, 37.8± 9.5 years）. Fracture occurred at T11,12 in 2 cases, T12L1 in 5 cases, L1,2 in 2 cases, L2,3 in 1 case, and L3,4 in 1 case. According to AO classification, all 11 cases were rated as type B. The thoracolumbar injury classification and severity score （TLICS） ranged from 7 to 10 （average, 9.2±0.87）. According to Frankel grading system, there were 3 cases of grade B, 4 cases of grade C, 3 eases of grade D, and 1 ease of grade E. The operative time, blood loss, and complications were evaluated. Functional recovery was evaluated by Frankel grading system. Radiographic results were obtained before surgery and during follow-up, and Cobb angle was measured. Results The operative time ranged from 130 to 170 minutes （average, 147.3±11.9 minutes）. The blood loss ranged from 180 to 650 ml （average, 369.1±110.2 ml）. All patients were followed up for 13 to 26 months （average, 20.2±4.3 months）. There was no complication during operation and follow-up. X-rays at final follow-up showed that there was no internal fixation failure such as screws break and cages shift. The improvement in Frankel grade was observed in 9 cases. The average Cobb angle improved from preoperative -10.3°±7.8° （range, -21.2° to 3.2°） to 1.2°±7.4° （range, -7.9° to 17.2°） at final follow-up. Conclusion The TIF is an effective method for treating thoracolumbar fracture, which shows good results in deformity correc- tion, improvement of neurological function, bone fusion and stability of internal fixation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2012年第12期1116-1120,共5页
Chinese Journal of Orthopaedics
基金
国家自然科学基金资助课题（81101378）,浙江省卫生高层次创新人才培养工程项目,浙江省科技厅社会发展项目（2009C03014-1）
关键词
胸椎
腰椎
脊柱骨折
脊柱融合术
Thoracic vertebrae
Lumbar vertebrae
Spinal fractures
Spinal fusion
