伤椎置钉植骨后路短节段固定治疗胸腰段骨折

发布时间：2018-04-02 21:06

  本文选题：胸腰椎　切入点：骨折　出处：《中国矫形外科杂志》2016年22期

【摘要】：[目的]观察经伤椎椎弓根置钉、植骨后路短节段固定治疗胸腰段压缩性骨折的临床疗效。[方法]2013年1月~2015年1月本院21例胸腰段压缩性骨折采用经伤椎椎弓根置钉、植骨后路短节段固定,术前CT检查测量椎管占位比,术前、术后、去除内固定前或末次随访时X线片测量骨折椎体前缘压缩率、Cobb角并评估神经功能情况。[结果]患者均顺利完成手术,受伤至手术时间平均4.7 d(1~13 d),伤口均Ⅰ期愈合,术后X线片示脊柱序列和生理曲度基本恢复。术前前柱平均压缩39.3%(19%~64%),术后即刻8.3%(1%~17%),手术矫正31%;末次随访前柱压缩14.6%(4%~20%),平均丢失6.3%。Cobb角术前平均18.7°(10°~29°),术后平均1.7°(-9°~6°),平均矫正17°,术后畸形得到明显改善;末次随访时Cobb角平均4.6°(-8°~10°),丢失2.9°。平均随访18个月(10~34个月),椎体骨折愈合,无内固定失败,脊髓神经不完全损伤神经功能均有不同程度恢复。[结论]经伤椎椎弓根置钉、植骨,后路短节段固定可恢复并有效维持矢状位序列,减少椎体矫正度的丢失及内固定并发症的发生,是治疗胸腰段压缩性骨折一种安全、有效的方法。
[Abstract]:[objective] to observe the clinical effect of transpedicular pedicle screw fixation and short segment fixation in the treatment of thoracolumbar compression fracture.[methods] from January 2013 to January 2015, 21 cases of thoracolumbar compression fractures were treated by pedicle screw insertion and short segment fixation after bone grafting. The ratio of spinal canal occupied by CT was measured before and after operation.The anterior compression ratio and Cobb angle of fracture vertebrae were measured by X ray film before removal of internal fixation or at the last follow-up.[results] all the patients completed the operation successfully. The average time from injury to operation was 4.7 days to 13 days. The wound was healed in the first stage. The X-ray film showed that the sequence and physiological curvature of the spinal column were basically recovered.鏈�鍓嶅墠鏌卞钩鍧囧帇缂�39.3%(19%~64%),鏈�鍚庡嵆鍒�8.3%(1%~17%),鎵嬫湳鐭�姝�31%;鏈�娆￠殢璁垮墠鏌卞帇缂�14.6%(4%~20%),骞冲潎涓㈠け6.3%.Cobb瑙掓湳鍓嶅钩鍧，

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