摘要
目的探讨跨伤椎后路短节段内固定在胸腰椎爆裂骨折患者中的临床效果及对椎体形态变化的影响。方法2017年5月—2017年12月延安市人民医院收治的胸腰椎爆裂骨折患者86例,男性52例,女性34例;年龄27~63岁,平均46.0岁。随机数字表法分为经伤椎组和跨伤椎组。经伤椎组行经伤椎椎弓根钉固定治疗,男性27例,女性16例;年龄28~61岁,平均45.7岁。跨伤椎组行跨伤椎后路短节段固定治疗,男性25例,女性18例;年龄27~63岁,平均46.6岁。术后对患者进行6个月电话、上门随访。比较两组椎体功能、Oswestry功能障碍评分及并发症发生率。结果跨伤椎组术后6个月椎体前后缘高度(90.59±7.84)%、椎间隙高度(54.34±6.39)mm、矢状径(79.43±4.31)%,均高于经伤椎组(64.79±6.33)%、(47.81±5.77)mm、(73.25±3.49)%(P<0.05);跨伤椎组术后6个月后凸畸形(13.29±1.96)°,低于经伤椎组(18.41±2.06)°(P<0.05);跨伤椎组术后1、3、6个月Oswestry功能障碍评分(14.68±4.12)分、(10.69±4.32)分、(7.21±3.56)分,均低于经伤椎组(20.12±4.69)分、(17.41±5.32)分、(13.23±4.39)分(P<0.05);两组患者术后断钉棒、骨折延迟愈合、椎体后凸畸形、椎弓根钉松动及硬脊膜撕裂发生率差异均无统计学意义(P>0.05)。结论跨伤椎后路短节段内固定用于胸腰椎爆裂骨折患者中能获得较高的近期疗效,能改善椎体形态变化,安全性较高,值得推广应用。
Objective To investigate the clinical effect of short-segmental fixation of the posterior segment of the injured vertebrae in patients with thoracolumbar burst fractures and its effect on morphological changes of the vertebral body.Methods From May 2017 to Dec.2017,86 patients with thoracolumbar burst fractures admitted to Yan an People s Hospital were randomly divided into the injured vertebrae group(n=43)and the trans-vertebral group(n=43).The injured vertebrae group was treated with pedicle screw fixation.There were 27 males and 16 females,aged 28-61 years,with an average of 45.73 years.Causes of injury included 19 cases of traffic accidents,14 cases of high altitude fall injuries,8 cases of bruises and 2 cases of other causes.The trans-vertebral group was treated with short-segmental fixation of the posterior segment of the injured vertebrae,with 25 males and 18 females aged 27-63 years,with an average of 46.59 years.Causes of injury included 20 cases of traffic accidents,14 cases of high altitude fall injury,6 cases of crush injury,and 3 cases of other causes.The patients were followed up for 6 months after treatment.The follow-up methods were based on telephone follow-up and home visits.The vertebral function,Oswestry dysfunction score,and complication rate were compared between the two groups.Results The height of the anterior and posterior margin of the vertebral body was(90.59±7.84)%,the height of the intervertebral space was(54.34±6.39)mm,and the sagittal diameter was(79.43±4.31)%in the trans-vertebral group,which were higher than those in the injured vertebrae group of(64.79±6.33)%,(47.81±5.77)mm,(73.25±3.49)%(P<0.05);after 6 months of surgery,the convex deformity was(13.29±1.96)°in the trans-vertebral group,which was lower than that of the injured vertebra group(18.41±2.06)°(P<0.05).Oswestry dysfunction scores were 14.68±4.12,10.69±4.32,and 7.21±3.56 at 1,3,and 6 months after surgery in the injured vertebrae group,respectively,all lower than those in the injured vertebrae group of 20.12±
作者
张中平
祁学强
杨明智
曹华佗
ZHANG Zhong-ping;QI Xue-qiang;YANG Ming-zhi;CAO Hua-tuo(First Orthopedic Ward of Yan an People s Hospital,Yan an,Shanxi 716000,China)
出处
《创伤外科杂志》
2019年第12期932-936,共5页
Journal of Traumatic Surgery
关键词
胸腰椎爆裂骨折
跨伤椎固定
经伤椎固定
椎体功能
thoracolumbar burst fracture
trans-vertebral fixation
injured vertebrae fixation
vertebral function
