胸腰椎骨折脱位经后路长节段内固定术后力线不良及其原因分析

发布时间：2019-01-05 17:07

【摘要】：目的分析严重胸腰椎骨折脱位经后路长节段椎弓根螺钉内固定术后脊柱冠状位力线、矢状位力线恢复不良的情况及其原因。方法分析33例胸腰椎骨折脱位(AO分型C型)病例,均接受后路长节段内固定手术。在X线平片上测量患者手术前、后伤椎移位距离、脊柱侧(后)凸Cobb角;根据术后力线恢复情况,将患者分为力线恢复良好组(A组)和力线恢复不良组(B组),并分析螺钉数目、伤椎置钉等对术后脊柱力线恢复的影响。结果 33例患者中,力线恢复良好占60.6%(20例),力线恢复不良占39.4%(13例)。两组患者固定节段和使用椎弓根螺钉总数方面的差异无统计学意义(P0.05);每个椎体椎弓根螺钉数目A组为(1.7±0.3)个,B组为(1.3±0.4)个,其差异有统计学意义(P0.05)。结论严重胸腰椎骨折后路长节段内固定术后力线恢复不良并非少见,固定节段、螺钉使用数目、伤椎置钉等对术后脊柱力线的恢复有重要影响。
[Abstract]:Objective to analyze the bad recovery of coronal and sagittal force lines of spinal column after posterior long segment pedicle screw fixation for severe thoracolumbar fracture and dislocation. Methods 33 cases of thoracolumbar fracture and dislocation (AO type C) were analyzed. The displacement distance of the injured vertebrae and the Cobb angle of the lateral (posterior) kyphosis were measured on the X-ray plain film before operation. According to the recovery of force line after operation, the patients were divided into two groups: group A (good recovery of force line) and group B (poor recovery of force line). The effect of screw number and screw insertion on the recovery of spinal force line after operation was analyzed. Results among 33 patients, good recovery rate was 60.6% (20 / 33) and poor recovery rate was 39.4% (13 / 33). There was no significant difference in the total number of fixed segments and pedicle screws between the two groups (P0.05). The number of pedicle screws in group A was (1.7 卤0.3), and that in group B was (1.3 卤0.4), the difference was statistically significant (P0.05). Conclusion it is not uncommon for severe thoracolumbar fracture to recover force line after long segment internal fixation. Fixation segment, number of screws and injured screw have important influence on the recovery of force line after thoracolumbar fracture.
【作者单位】：南方医科大学南方医院脊柱骨科;
【分类号】：R687.3

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