小开窗减压短力臂伤椎置钉复位内固定术治疗胸腰椎爆裂性骨折

发布时间：2018-03-19 18:27

本文选题：脊柱骨折　切入点：胸椎　出处：《中医正骨》2016年11期 　论文类型：期刊论文

【摘要】：目的:观察小开窗减压短力臂伤椎置钉复位内固定术治疗胸腰椎爆裂性骨折的临床疗效和安全性。方法:2010年1月至2015年1月,采用小开窗减压短力臂伤椎置钉复位内固定术治疗胸腰椎爆裂性骨折患者38例,男24例、女14例。年龄20~63岁,中位数43岁。损伤椎体,T_(10)2例、T_(11)6例、T_(12)14例、L_110例、L_26例。按脊髓损伤的Frankel分级,A级3例、B级4例、C级14例、D级10例、E级7例。伤后至手术时间1~16 d,中位数4 d。术后随访观察骨折愈合、椎体高度恢复、后凸畸形矫正、脊髓神经功能恢复及并发症发生情况。结果:所有患者均获随访,随访时间12~24个月,中位数16个月。骨折均获骨性愈合。术后1周与术后12个月伤椎椎体高度丢失率[(伤椎相邻上下椎体高度的平均值-伤椎椎体高度)"伤椎相邻上下椎体高度的平均值×100%)]分别由术前(44.83±12.73)%降低至(10.24±7.25)%、(13.11±8.51)%,Cobb角由术前31.49°±14.17°降低至6.90°±5.15°、8.74°±6.39°。术后12个月,部分病例的脊髓神经功能有所恢复;按脊髓损伤的Frankel分级,A级3例、B级1例、C级2例、D级12例、E级20例。均无内固定断裂、松动等并发症发生。结论:采用小开窗减压短力臂伤椎置钉复位内固定术治疗胸腰椎爆裂性骨折,创伤小,能促进骨折愈合,恢复椎体高度,纠正后凸畸形,有利于脊髓神经功能的恢复,且并发症少,值得临床推广应用。
[Abstract]:Objective: to observe the clinical efficacy and safety of small fenestration, decompression, short arm injury, reduction and internal fixation for thoracolumbar burst fracture. Methods: from January 2010 to January 2015, the treatment of thoracolumbar burst fracture was performed. 38 patients (24 males and 14 females) with thoracolumbar burst fracture were treated with small fenestration, decompression, short arm injury, reduction and internal fixation. The median was 43 years old. There were 116 cases of Tastoma and 116 cases of Tastoma. According to the Frankel grade of spinal cord injury, 3 cases were grade A, 4 cases were grade C, 10 cases were grade D, 7 cases were grade E. The time from injury to operation was 116 days, and the median was 4 days. The fracture healing was observed after operation, and the fracture healing was observed after operation, according to the Frankel grade of spinal cord injury, 3 cases with grade A and 14 cases with grade C and grade C, grade C and grade D, grade C and grade E in 7 cases, the operative time from injury to operation was 1 16 days, the median was 4 days. Results: all the patients were followed up for 12 ~ 24 months. Median 16 months. Bone union was achieved in all fractures. Loss rate of vertebral height at 1 week and 12 months after operation [(average of upper and lower vertebral height of injured vertebrae-height of injured vertebra) "level of height of adjacent upper and lower vertebrae of injured vertebra. The mean value of Cobb decreased from 44.83 卤12.73% to 10.24 卤7.25% from 44.83 卤12.73% to 13.11 卤8.51 掳from 31.49 掳卤14.17 掳to 6.90 掳卤5.15 掳8.74 掳卤6.39 掳, respectively, 12 months after operation, the mean value of Cobb decreased from 31.49 掳卤14.17 掳to 6.90 掳卤5.15 掳卤8.74 掳卤6.39 掳. The neurological function of spinal cord recovered in some cases, according to the Frankel grade of spinal cord injury, there were 3 cases of grade A, 1 case of grade B, 2 cases of grade C, 12 cases of grade D and 20 cases of grade E, all of which had no fracture of internal fixation. Conclusion: the treatment of thoracolumbar burst fracture with small fenestration, decompression, short arm injury and reduction and internal fixation can promote fracture healing, recover vertebral body height and correct kyphosis deformity. It is beneficial to the recovery of spinal cord nerve function and has fewer complications, so it is worth popularizing in clinic.
【作者单位】：河南省洛阳正骨医院/河南省骨科医院;
【分类号】：R687.3

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