中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
29期
2082-2085
,共4页
郭开今%李宏伟%张新珠%袁峰
郭開今%李宏偉%張新珠%袁峰
곽개금%리굉위%장신주%원봉
脊柱骨折%内固定器%骨移植
脊柱骨摺%內固定器%骨移植
척주골절%내고정기%골이식
Spinal fractures%Internal fixators%Bone transplantation
目的 探讨经弹性环钻行伤椎内植骨的可行性及操作方法.方法 回顾性分析2003年3月至2009年7月采用椎弓根内固定加经弹性环钻伤椎内植骨治疗的42例胸腰椎骨折患者的术前、术后及随访期间的胸腰椎X线片,测量伤椎高度与正常高度的比值、脊柱后凸Cobb角及矢状位指数.结果 术后随访12～26个月,平均14.8个月,骨折均达到满意复位并愈合,伤椎高度、Cobb角、矢状位指数均得到明显恢复,未发生内固定断裂和螺钉松动现象,也无明显矫正度丢失现象.结论 经弹性环钻行伤椎内植骨重建了椎体高度,增加了脊柱前柱的抗压稳定性,可有效地防止内固定失败和矫正度丢失.弹性环钻使用方便,兼有辅助复位、植骨重建的双重作用.
目的 探討經彈性環鑽行傷椎內植骨的可行性及操作方法.方法 迴顧性分析2003年3月至2009年7月採用椎弓根內固定加經彈性環鑽傷椎內植骨治療的42例胸腰椎骨摺患者的術前、術後及隨訪期間的胸腰椎X線片,測量傷椎高度與正常高度的比值、脊柱後凸Cobb角及矢狀位指數.結果 術後隨訪12～26箇月,平均14.8箇月,骨摺均達到滿意複位併愈閤,傷椎高度、Cobb角、矢狀位指數均得到明顯恢複,未髮生內固定斷裂和螺釘鬆動現象,也無明顯矯正度丟失現象.結論 經彈性環鑽行傷椎內植骨重建瞭椎體高度,增加瞭脊柱前柱的抗壓穩定性,可有效地防止內固定失敗和矯正度丟失.彈性環鑽使用方便,兼有輔助複位、植骨重建的雙重作用.
목적 탐토경탄성배찬행상추내식골적가행성급조작방법.방법 회고성분석2003년3월지2009년7월채용추궁근내고정가경탄성배찬상추내식골치료적42례흉요추골절환자적술전、술후급수방기간적흉요추X선편,측량상추고도여정상고도적비치、척주후철Cobb각급시상위지수.결과 술후수방12～26개월,평균14.8개월,골절균체도만의복위병유합,상추고도、Cobb각、시상위지수균득도명현회복,미발생내고정단렬화라정송동현상,야무명현교정도주실현상.결론 경탄성배찬행상추내식골중건료추체고도,증가료척주전주적항압은정성,가유효지방지내고정실패화교정도주실.탄성배찬사용방편,겸유보조복위、식골중건적쌍중작용.
Objective To evaluate the feasibility and surgical procedure of bone grafting with elastic trephine. Methods A total of 42 cases of thoracolumbar fracture received pedicle screw fixations by combining bone grafting with elastic trephine through pedicle of fractured vertebra. The ratios of the altitude of traumatic vertebra to normal altitude, kyphosis Cobb angle and sagittal index were measured by preoperative and postoperative X-ray images. Results A follow-up visit of 12-26 months (average: 14. 8)showed that the dislocations of vertebrae were corrected and fusions completed. Proportion of the height of anterior edge of traumatic vertebra to normal height was ( 53.89 ± 6. 57 ) % at pre-operation, ( 92. 31 ±11.25) % at post-operation and ( 91.39 ± 10. 28 ) % at an one-year follow-up ( P ＜ 0. 05 ). The kyphosis was (23. 19 ±5.74) ° Cobb angle at pre-operation, (4. 92 ± 1.03 ) ° at post-operation and (5.13 ± 1.41 ) °at an one-year follow-up ( P ＜ 0. 05 ). In contrast with 86% (78 % -97% ) on average at post-operation, the pre-operative sagittal index was 54% (32% -66% ) on average. Conclusion Application of bone grafting with elastic trephine can reconstruct the altitude of injured vertebral body, increase the compressive stability of anterior column as well as effectively correct the kyphosis deformity. With a convenient application,elastic trephine plays a variety of roles in both auxiliary reduction and bone grafting reconstruction.
