一期后路椎体次全切除,钛网重建联合经伤椎椎弓根钉内固定治疗严重多节段胸腰椎骨折临床观察

发布时间：2018-06-29 18:48

本文选题：多节段胸腰椎骨折 + 后路　；参考：《天津医科大学学报》2016年06期

【摘要】：目的:探讨一期后路椎体次全切除,钛网重建联合经伤椎椎弓根钉内固定治疗严重的多节段胸腰椎骨折的疗效。方法:回顾性分析11例行一期后路椎体次全切除,钛网重建联合经伤椎椎弓根钉内固定治疗严重多节段胸腰椎骨折患者的临床资料。比较术前及术后患者的椎管内容积、椎体高度、后凸角及椎体复位情况,神经功能恢复情况,评估临床疗效。结果:所有患者均获得随访,脱位椎体均完全复位,患者非严重节段骨折术前椎体前缘高度与后缘比值平均为(40.7±5.1)%,术后为(72.7±4.7)%,后凸角术前为(29.2±6.3)°,术后为(9.2±3.1)°;严重骨折节段术前后凸角度后凸(15.6±1.4)°,术后为前凸(19.7±2.7)°,椎管内骨块占位面积术前(81.2±3.2)%,术后为0,差异均有统计学意义(P0.01)。7例患者的神经功能有不同程度恢复。结论:一期后路椎体次全切除,钛网重建联合经伤椎椎弓根钉内固定治疗有利于恢复多节段骨折椎体高度、胸腰椎的生理曲度和神经功能,具有良好的临床疗效。
[Abstract]:Objective: to evaluate the effect of one stage posterior subtotal vertebra resection and titanium mesh reconstruction combined with pedicle screw fixation in the treatment of severe multiple thoracolumbar fractures. Methods: the clinical data of 11 patients with severe multiple thoracolumbar fractures treated by posterior subtotal vertebra resection and titanium mesh reconstruction combined with pedicle screw fixation were retrospectively analyzed. The volume of vertebral canal, height of vertebral body, kyphosis angle and reduction of vertebral body, recovery of nerve function were compared before and after operation. Results: all the patients were followed up and the dislocation vertebrae were completely reduced. The average ratio of anterior height to posterior margin of nonsevere segmental fractures was (40.7 卤5.1) before operation, (72.7 卤4.7) after operation, (29.2 卤6.3) 掳before operation and (9.2 卤3.1) 掳after kyphosis angle, (15.6 卤1.4) 掳and (19.7 卤2.7) 掳after operation in severe segmental fractures. Before and after operation (81.2 卤3.2), the difference was statistically significant (P0.01). Conclusion: one stage posterior subtotal vertebral body resection, titanium mesh reconstruction combined with pedicle screw fixation is beneficial to the recovery of vertebral body height, physiological curvature and nerve function of thoracolumbar vertebrae, and has a good clinical effect.
【作者单位】：天津医科大学研究生院;天津市人民医院脊柱外科;
【分类号】：R687.3

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