膨胀式椎弓根螺钉治疗中老年骨质疏松性胸腰段脊柱爆裂性骨折的疗效

发布时间：2018-04-02 00:14

本文选题：胸腰段　切入点：脊柱　出处：《中国老年学杂志》2017年07期

【摘要】：目的探讨膨胀型椎弓根钉(EPS)结合伤椎普通椎弓根钉固定治疗中老年骨质疏松性胸腰段脊柱爆裂骨折的临床疗效。方法选择27例中老年骨质疏松性胸腰段脊柱爆裂骨折患者行后路EPS结合伤椎普通椎弓根钉固定术。术后随访观察椎体前后缘高度改善情况、伤椎Cobb角、术前及术后视觉疼痛评分(VAS)、椎弓根螺钉稳定性及脊柱融合情况,术后Beaujon-Lassale功能评分。结果 27例患者术后随访18~31〔平均(24±2.7)个月〕,其中5例于术后18~24〔平均(21.5±2.2)个月〕行内固定取出术;所有患者螺钉稳定性及骨融合良好;术后1 w伤椎前、后缘高度、脊柱后凸Cobb角及VAS评分均较术前有显著改善(P0.05),而末次随访时各项指标与术后1 w比较差异无统计学意义(P0.05);末次随访时Beaujon-Lassale功能评分为(19.2±2.7)分。随访期间内固定无松动、断裂等;1例患者出现腰背部疼痛症状,予以局部理疗、药物治疗等对症治疗,术后1个月症状完全恢复。结论经后路EPS结合伤椎普通椎弓根钉固定治疗中老年骨质疏松性胸腰段脊柱爆裂骨折在促进骨折愈合、改善疼痛及减少术后后凸畸形方面均具有良好的临床疗效。
[Abstract]:Objective to investigate the clinical effect of expandable pedicle screw (EPS) combined with common pedicle screw fixation in the treatment of osteoporotic thoracolumbar burst fracture.Methods 27 cases of osteoporotic thoracolumbar spinal burst fracture were treated with posterior EPS combined with common pedicle screw fixation.Postoperative follow-up was performed to observe the improvement of anterior and posterior edge height of vertebral body, Cobb angle of injured vertebra, visual pain score before and after operation, pedicle screw stability and spinal fusion, and postoperative Beaujon-Lassale score.Results 27 patients were followed up for 18: 31 (mean 24 卤2. 7) months after operation, 5 of them were treated with internal fixation at 18: 24 (mean, 21.5 卤2. 2) months, all the patients had good screw stability and bone fusion, 1 week after operation, the height of the anterior and posterior margin of the injured vertebrae was high.The Cobb angle and VAS score of kyphosis were significantly improved compared with those before operation (P 0.05), but there was no significant difference between the indexes at the last follow-up and 1 week after operation (P 0.05), and the score of Beaujon-Lassale function at the last follow-up was 19.2 卤2.7).During the follow-up period, there was no loosening, rupture and other symptoms in 1 case of lumbar and back pain, which were treated with local physiotherapy and drug therapy, and the symptoms recovered completely 1 month after operation.Conclusion the treatment of thoracolumbar burst fracture with posterior EPS combined with common pedicle screw fixation of injured vertebrae has a good clinical effect in promoting fracture healing, improving pain and reducing postoperative kyphosis.
【作者单位】：重庆医科大学附属永川医院骨科;重庆医科大学附属第一医院骨科;
【基金】：教育部高校博士点基金(No.20125503120017)
【分类号】：R687.3;R580

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