预弯棒预防胸腰椎骨折前路手术后侧方成角

发布时间：2018-10-30 14:54

【摘要】：[目的]分析预弯棒在预防胸腰椎骨折前路手术后脊柱出现侧方成角的效果。[方法]回顾性分析2010年9月~2015年6月本院胸腰椎骨折前路手术患者共218例,其中影像学资料完整的208例。评估每一位患者的影像资料,测量椎体螺钉与终板的夹角,208例中男139例,女69例,年龄16~68岁,平均(38.1±14.9)岁。损伤类型:车祸31例,重物砸伤23例,高处坠落伤154例。骨折椎体节段:T_(11)2例,T_(12)18例,L_1137例,L_241例,L_39例,L_41例;骨折椎体AO分型:A型194例,B型14例;脊髓损伤Frankel分级:A级53例,B级11例,C级35例,D级39例,E级70例。内固定材料:Antares(美敦力公司)197例和Z-Plate(美敦力公司)11例。208例中有20例术中通过预弯连接棒预防可能形成的侧方成角,20例中男14例,女6例,年龄28~53岁,平均(35.3±20.1)岁。损伤类型:车祸6例,重物砸伤1例,高处坠落13例。骨折椎体节段:T_(11)0例,T_(12)1例,L_115例,L_23例,L_31例;骨折椎体AO分型:A型20例;脊髓损伤Frankel分级:A级5例,B级1例,C级3例,D级4例,E级7例。内固定材料:全部应用Antares脊柱前路内固定系统(美敦力公司)。[结果]全部病例中有9例术后出现超过5°以上的侧方成角,没有10°以上的侧方成角。术前侧方成角平均1.31°±4.09°,术后侧方成角平均2.19°±3.78°,术前与术后冠状面Cobb角比较差异无统计学意义。20例应用预弯棒的患者术中均出现椎体螺钉与相应的终板较大的成角,但术后均没有出现超过5°以上的侧方成角。术前侧方成角平均2.11°±4.26°,术后侧方成角平均2.31°±3.58°,术前与术后冠状面Cobb角比较差异无统计学意义。[结论]预弯棒可以有效地预防胸腰椎骨折前路手术术后脊柱侧方成角的发生。
[Abstract]:Objective: to analyze the effect of prebending bar in preventing lateral angulation of spinal column after thoracolumbar fracture. [methods] 218 patients with thoracolumbar fractures were analyzed retrospectively from September 2010 to June 2015, including 208 cases with complete imaging data. The imaging data of each patient were evaluated and the angle between vertebral screw and endplate was measured. There were 139 males and 69 females with a mean age of (38.1 卤14.9) years. Injury type: 31 cases of traffic accident, 23 cases of heavy object injury, 154 cases of falling injury. There were 2 cases of T _ (11), 18 cases of T _ (12), 1137 cases of L _ s, 241 cases of L _ s, 39 cases of L _ s, 41 cases of L _ S, AO classification of fracture vertebral body: type A 194 cases, B type 14 cases; Frankel classification of spinal cord injury: 53 cases of grade A, 11 cases of grade B, 35 cases of grade C, 39 cases of grade D and 70 cases of grade E. There were 197 cases of internal fixation material: Antares (Medtronic Company and 11 cases of Z-Plate. 20 of 208 cases were prevented from forming lateral angle by prebending connecting rod during operation, of which 14 cases were males and 6 cases were females, aged 2853 years. The mean age was (35.3 卤20.1) years. Injury type: 6 cases of traffic accident, 1 case of heavy object smashing, 13 cases of falling from height. Fracture vertebral segment: T11, T12, L115, L23, L31, AO classification: type A, type A. Frankel classification of spinal cord injury: 5 cases were grade A, 1 case was grade B, 3 cases were grade C, 4 cases were grade D, and 7 cases were grade E. Internal fixation materials: Antares anterior spinal internal fixation system (Medtronic). [results] there were more than 5 掳lateral angulation in 9 cases after operation, but no more than 10 掳lateral angulation. The mean lateral angle was 1.31 掳卤4.09 掳before operation and 2.19 掳卤3.78 掳after operation. There was no significant difference in Cobb angle between preoperative and postoperative coronal plane. In 20 patients with prebending rod, there were larger angles of vertebral screw and corresponding endplate during operation, but no lateral angle more than 5 掳was found after operation. The mean lateral angle was 2.11 掳卤4.26 掳before operation and 2.31 掳卤3.58 掳after operation. There was no significant difference in Cobb angle between preoperative and postoperative coronal plane. Conclusion: prebending bar can effectively prevent lateral angulation of thoracolumbar fractures after anterior operation.
【作者单位】：四川大学华西医院骨科;
【分类号】：R687.3

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