1 病例资料 患者男,21岁,2017年8月底弯腰搬举重物后出现下腰部疼痛,持续半个月未见好转,于9月12日就诊。体格检查:腰部最下方2个棘突间隙压痛,弯腰略受限,视觉模拟量表(visual analog scale,VAS)评分5分。下肢感觉运动正常。考虑棘间...1 病例资料 患者男,21岁,2017年8月底弯腰搬举重物后出现下腰部疼痛,持续半个月未见好转,于9月12日就诊。体格检查:腰部最下方2个棘突间隙压痛,弯腰略受限,视觉模拟量表(visual analog scale,VAS)评分5分。下肢感觉运动正常。考虑棘间韧带损伤。给予口服云南白药胶囊(云南白药集团股份有限公司)及外敷云南白药膏(云南白药集团股份有限公司)、红药贴膏(沈阳红药集团股份有限公司)治疗,建议避免弯腰负重。1周后腰痛减轻,但出现左小腿外侧放射性麻木,遂复诊。体格检查:腰椎最下2个棘突间隙及左旁压痛,VAS评分4分,叩击时疼痛向左小腿外侧放射;左下肢直腿抬高60°,加强试验阳性;小腿外侧痛觉过敏,VAS评分4分;左踝反射减弱。呈左L5、S1神经根受压激惹表现。展开更多
Objective： To prospectively evaluate the feasibility, safety and efficacy of the percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using ...Objective： To prospectively evaluate the feasibility, safety and efficacy of the percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system in the retrospective non-randomized case-control study. Methods： Atotal of 38 consecutive non-randomized patients with type A thoracolumbar fractures, which had been stabilized posteriorly from December 2006 to March 2009, were examined retrospectively more than 9 months after surgery. Twenty-one patients had been treated conventionally with open pedicle screw fixation （OPSF） and 17 patients received minimally invasive treatment with Sextant percutaneous pedicle screw fixation （SPPSF）. As a method of evaluation, the incision size, the intraoperation and post- operative volume of blood loss, operation time, postoperative hospital stay, blood transfusion, the radiological assessment of the sagittal Cobb＇s angle, vertebral body angle and vertebral body height were recorded and compared. Results： All patients were followed up for 8-24 months （average 11.6 months）. There were significant differences in the incision size, surgical blood loss, surgical draining Joss, operation time, hospital stay after operation, blood transfusion, the proportion of antalgic supplement and postoperative incisional VAS between the two groups （P〈0.05）. Mean preoperative kyphotic deformity was 16.0° and improved by 9.3° after surgery in OPSF group, but 15.2° and 10.3° respectively in SPPSF group. Mean preoperative angle of the fractured vertebral body was 15.9°and improved by 7.9° after surgery in OPSF group, but 14.9° and 6.6° respectively in SPPSF group. Mean anterior vertebral body height （% of normal） was 67.3% before surgery and 95.8% after surgery, but 69.1% and 90.1% respectively in SPPSF group. Mean posterior vertebral body height （% of normal） was 93.3% before surgery and 99.5% after surgery, but 88.9% and 93.3% respectively in SPPSF group. Among the patien展开更多
文摘1 病例资料 患者男,21岁,2017年8月底弯腰搬举重物后出现下腰部疼痛,持续半个月未见好转,于9月12日就诊。体格检查:腰部最下方2个棘突间隙压痛,弯腰略受限,视觉模拟量表(visual analog scale,VAS)评分5分。下肢感觉运动正常。考虑棘间韧带损伤。给予口服云南白药胶囊(云南白药集团股份有限公司)及外敷云南白药膏(云南白药集团股份有限公司)、红药贴膏(沈阳红药集团股份有限公司)治疗,建议避免弯腰负重。1周后腰痛减轻,但出现左小腿外侧放射性麻木,遂复诊。体格检查:腰椎最下2个棘突间隙及左旁压痛,VAS评分4分,叩击时疼痛向左小腿外侧放射;左下肢直腿抬高60°,加强试验阳性;小腿外侧痛觉过敏,VAS评分4分;左踝反射减弱。呈左L5、S1神经根受压激惹表现。
文摘Objective： To prospectively evaluate the feasibility, safety and efficacy of the percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system in the retrospective non-randomized case-control study. Methods： Atotal of 38 consecutive non-randomized patients with type A thoracolumbar fractures, which had been stabilized posteriorly from December 2006 to March 2009, were examined retrospectively more than 9 months after surgery. Twenty-one patients had been treated conventionally with open pedicle screw fixation （OPSF） and 17 patients received minimally invasive treatment with Sextant percutaneous pedicle screw fixation （SPPSF）. As a method of evaluation, the incision size, the intraoperation and post- operative volume of blood loss, operation time, postoperative hospital stay, blood transfusion, the radiological assessment of the sagittal Cobb＇s angle, vertebral body angle and vertebral body height were recorded and compared. Results： All patients were followed up for 8-24 months （average 11.6 months）. There were significant differences in the incision size, surgical blood loss, surgical draining Joss, operation time, hospital stay after operation, blood transfusion, the proportion of antalgic supplement and postoperative incisional VAS between the two groups （P〈0.05）. Mean preoperative kyphotic deformity was 16.0° and improved by 9.3° after surgery in OPSF group, but 15.2° and 10.3° respectively in SPPSF group. Mean preoperative angle of the fractured vertebral body was 15.9°and improved by 7.9° after surgery in OPSF group, but 14.9° and 6.6° respectively in SPPSF group. Mean anterior vertebral body height （% of normal） was 67.3% before surgery and 95.8% after surgery, but 69.1% and 90.1% respectively in SPPSF group. Mean posterior vertebral body height （% of normal） was 93.3% before surgery and 99.5% after surgery, but 88.9% and 93.3% respectively in SPPSF group. Among the patien
