经伤椎和跨伤椎螺钉置入固定胸腰椎压缩性骨折:脊柱稳定性长期随访

发布时间：2018-03-01 05:22

本文关键词： 腰椎胸椎骨折出血输血组织工程骨科植入物脊柱植入物压缩性骨折 Cobb角伤椎前缘高度目测类比评分湖北省自然科学基金　出处：《中国组织工程研究》2016年04期 　论文类型：期刊论文

【摘要】：背景:经后路椎弓根螺钉置入内固定是胸腰椎压缩性骨折常用的修复方式之一,其固定方式又包括长节段固定、短节段固定及经伤椎固定等多种方式。其中经伤椎单节段固定及跨伤椎短节段固定修复胸腰椎骨折的临床疗效尚未明确。目的:比较后路经伤椎与跨伤椎椎弓根螺钉置入内固定修复胸腰椎压缩性骨折的稳定性。方法:回顾性分析46例胸腰椎压缩性骨折患者的临床资料,根据内固定方式分为经伤椎固定组(n=21)和跨伤椎固定组(n=25)。对两组患者的手术时间、术中出血、术中输血、卧床时间,以及伤椎Cobb角、伤椎前缘高度和目测类比评分进行长期随访评价。结果与结论:(1)两组患者在修复治疗过程中,跨伤椎组在手术时间,术中出血和术中输血方面要优于经伤椎组(P0.05-0.01),经伤椎组在卧床时间上优于跨伤椎组(P0.01)。(2)Cobb角和伤椎前缘高度方面,两组在治疗前、治疗后和及修复纠正方面差异未见显著性意义,而经伤椎组在末次随访和随访丢失方面要优于跨伤椎组(P0.05-0.01)。(3)在目测类比评分方面,两组组间比较,治疗前、治疗后差异均无显著性意义,而经伤椎组在末次随访时要优于跨伤椎组,差异有显著性意义(P0.01)。(4)提示经长期随访两种方式均能获得较满意的修复效果,与跨伤椎组相比经伤椎组在维持脊柱的高度和曲度方面优势更加明显,可更加有效的重建脊柱生理序列并恢复其稳定性,修复后腰背痛也可以得到有效控制。
[Abstract]:Background: transpedicular screw fixation is one of the commonly used methods for the repair of thoracolumbar vertebral compression fractures. The clinical effect of short segment fixation and transpedicular fixation on thoracolumbar fractures has not been determined. Objective: to compare the posterior and transpedicular pedicle fixation of thoracolumbar fractures. The stability of thoracolumbar vertebral compression fracture was repaired by screw fixation. Methods: the clinical data of 46 patients with thoracolumbar vertebral compression fracture were analyzed retrospectively. According to the method of internal fixation, the patients were divided into two groups: the injured vertebral fixation group (n = 21) and the transtraumatic vertebral fixation group (n = 25). The operative time, intraoperative bleeding, intraoperative blood transfusion, bed rest time, and Cobb angle of the injured vertebrae were observed in the two groups. The anterior height of injured vertebrae and visual analogies were evaluated for a long time. Results and conclusion: during the repair and treatment of the two groups of patients, the time of operation was observed in the cross-injured vertebra group. The intraoperative bleeding and intraoperative blood transfusion were better than that of the injured vertebra group (P 0.05-0.01), and the trabecular vertebra group was better than the transtraumatic vertebra group in the bed-rest time (P 0.01) and the anterior height of the injured vertebrae. There was no significant difference between the two groups before treatment, after treatment and in repair and correction. The visual analogue score of the injured vertebra group was better than that of the trans-injured vertebra group in the last follow-up and the loss of follow-up. There was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups in visual analogue score. At the last follow-up, the injured vertebra group was better than the trans-injured vertebra group, and the difference was significant (P 0.01). Compared with the trans-injured vertebra group, the injured vertebrae group has more obvious advantages in maintaining the height and curvature of the spine, and can more effectively reconstruct the physiological sequence of the spine and restore its stability, and the backache can also be effectively controlled after the repair.
【作者单位】：湖北省鄂州市中心医院骨科;武汉大学中南医院骨科;
【基金】：2013年湖北省自然科学基金资助项目(2013CFB269)~~
【分类号】：R687.3

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