椎体间融合治疗胸腰椎骨折伴椎间盘损伤

发布时间：2018-04-30 17:19

本文选题：椎间融合 + 胸椎　；参考：《中国矫形外科杂志》2017年16期

【摘要】：[目的]探讨椎体间融合治疗胸腰椎骨折伴椎间盘损伤的临床疗效。[方法]对2010年3月~2014年5月收治的56例严重胸腰椎骨折伴椎间盘损伤患者的资料进行回顾性分析,其中男38例,女18例;年龄21~57岁,平均42.50岁。骨折按AO-ASIF分型:A型6例,B型39例,C型11例;神经功能根据Frankel分级:A级2例,B级4例,C级6例,D级39例,E级5例。均采用后路减压、椎弓根螺钉固定,结合椎间融合进行治疗。比较术前、术后1周、术后3个月、末次随访的VAS评分、伤椎前缘高度比、Cobb角。[结果]随访时间18~37个月,平均21.3个月,无内固定失败、无后凸畸形发生。伤椎前缘高度比由术前平均(37.19±4.60)%恢复到术后(87.11±3.75)%,末次随访时为(85.32±3.97)%,术前与术后及末次随访比较差异均有统计学意义(P0.05);矢状面Cobb角由术前平均(20.19±2.48)°降低到术后(1.82±0.85)°,末次随访时为(2.21±0.71)°,术前与术后及末次随访比较差异均有统计学意义(P0.05);VAS评分由术前平均(7.75±1.08)降低到术后(2.18±0.64),末次随访时为(1.37±0.75),差异有统计学意义(P0.05)。各观察指标术后不同时间节点之间比较差异均无统计学意义(P0.05)。[结论]采用椎间融合治疗严重胸腰椎骨折可以有效矫正后凸、维持伤椎高度,临床疗效满意。
[Abstract]:Objective to investigate the clinical effect of interbody fusion in the treatment of thoracolumbar fracture with disc injury. [methods] the data of 56 patients with severe thoracolumbar fractures with disc injury from March 2010 to May 2014 were retrospectively analyzed, including 38 males and 18 females, with an average age of 42.50 years. According to AO-ASIF classification, there were 6 cases of type A, 39 cases of type B, 11 cases of type C, and 5 cases of neurological function according to Frankel grade: 2 cases of grade A, 4 cases of grade B, 6 cases of grade C, 39 cases of grade D and 5 cases of grade E. All patients were treated with posterior decompression, pedicle screw fixation and intervertebral fusion. Compared with the VAS scores of preoperative, 1 week, 3 months and last follow-up, the anterior edge height of the injured vertebrae was higher than that of the Cobb angle. [results] the follow-up time was 18 ~ 37 months (mean 21.3 months). No internal fixation failure and no kyphosis occurred. The ratio of anterior height of injured vertebrae recovered from 37.19 卤4.60% before operation to 87.11 卤3.75 after operation and 85.32 卤3.97 at the last follow-up. There were significant differences between preoperative, postoperative and last follow-up, and the sagittal Cobb angle decreased from 20.19 卤2.48 掳before operation to 1.82 卤0.85 掳after the last follow-up. In order to be 2.21 卤0.71 掳, the difference between preoperative and postoperative and last follow-up was statistically significant (P 0.05 卤1.08). The VAS score was reduced from 7.75 卤1.08 to 2.18 卤0.64, and at the last follow-up was 1.37 卤0.75, the difference was statistically significant (P 0.05). There was no significant difference between the nodes at different time after operation (P 0.05). [conclusion] Intervertebral fusion for severe thoracolumbar fractures can effectively correct kyphosis and maintain the height of injured vertebrae.
【作者单位】：中国人民解放军武汉总医院骨科;
【基金】：湖北省卫计委资助项目(编号:WJ2017H0042)
【分类号】：R687.3

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