胸腰段爆裂骨折伤椎内植骨术后矢状面形态变化

发布时间：2018-09-17 17:50

【摘要】：[目的]分析后路短节段椎弓根螺钉固定联合伤椎内植骨对胸腰段爆裂骨折椎体矢状面形态变化的影响。[方法]回顾性分析2014年1月~2017年1月因胸腰段爆裂骨折在本科行后路短节段椎弓根螺钉固定+伤椎内植骨术的41例患者的临床及影像学资料,根据CT矢状面重建图像,比较分析手术前后椎体前缘高度、椎体中央高度、Cobb角的变化,同时分析椎体骨折块向椎管内压迫程度的改善情况。[结果]41例患者均顺利完成手术,椎体前缘高度由术前(53.31±9.12)%恢复至术后的(98.23±8.68)%(P0.001),椎体中央高度由术前(64.14±8.79)%恢复至术后的(92.52±6.01)%(P0.001),Cobb角由术前(22.92±6.88)°恢复至术后的(8.17±6.06)°(P0.001),骨折块压迫程度由术前(31.12±11.66)%恢复至术后的(9.30±4.68)%(P0.001),椎体前缘高度恢复量为(44.92±3.90)%,优于椎体中央高度恢复量(28.38±3.67)%(P0.001)。[结论]后路短节段椎弓根螺钉固定联合伤椎内植骨术能有效恢复椎体前缘高度,矫正后凸畸形,并通过间接复位的方式改善椎管内压迫,但并不能完全有效恢复椎体中央高度。
[Abstract]:[objective] to analyze the effect of posterior short segment pedicle screw fixation combined with injured bone graft on the sagittal morphology of thoracolumbar burst fracture. [methods] the clinical and imaging data of 41 patients with thoracolumbar burst fracture treated with posterior short pedicle screw fixation for thoracolumbar burst fracture from January 2014 to January 2017 were analyzed retrospectively. According to CT sagittal plane reconstruction images, the clinical and imaging data of 41 patients with thoracolumbar burst fracture were analyzed retrospectively. The changes of anterior height and central height of vertebral body and Cobb angle before and after operation were compared and the improvement of compression degree of vertebral body fracture into the vertebral canal was analyzed at the same time. [results] all 41 patients completed the operation successfully. The anterior height of vertebral body recovered from (53.31 卤9.12)% before operation to (98.23 卤8.68)% (P0.001) after operation, the height of central vertebral body recovered from (64.14 卤8.79)% before operation to (92.52 卤6.01)% (P 0.001) after operation, the Cobb angle recovered from (22.92 卤6.88) 掳before operation to (8.17 卤6.06) 掳(P0.001) after operation, the compression degree of fracture block recovered from (31.12 卤11.66)% before operation to (9.30 卤4.68)% after operation (P0.001), and the height of anterior edge of vertebral body recovered from (22.92 卤6.88) 掳before operation to (8.17 卤6.06) 掳(P0.001) after operation, and the anterior height of vertebral body recovered from (31.12 卤11.66)% to (9.30 卤4.68)% (P0.001). The amount of recovery was (44.92 卤3.90), which was better than that of the central vertebral body (28.38 卤3.67)% (P0.001). [conclusion] posterior short segment pedicle screw fixation combined with traumatic bone grafting can effectively restore the height of the anterior edge of the vertebral body, correct kyphosis, and improve the compression of the spinal canal by indirect reduction. But it is not completely effective to restore the central height of the vertebral body.
【作者单位】：江苏大学附属医院脊柱外科;江苏大学医学院影像教研室;
【基金】：江苏省医学重点人才项目(科教兴卫工程-青年人才,编号:QNRC2016844)
【分类号】：R687.3

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