中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2010年
7期
605-608
,共4页
张强%纪玉清%胡樵%焦峰%韩磊祥%丛伟%黄勇%周秉文
張彊%紀玉清%鬍樵%焦峰%韓磊祥%叢偉%黃勇%週秉文
장강%기옥청%호초%초봉%한뢰상%총위%황용%주병문
脊柱骨折%胸椎%腰椎%骨折固定术,内
脊柱骨摺%胸椎%腰椎%骨摺固定術,內
척주골절%흉추%요추%골절고정술,내
Spinal fractures%Thoracic vertebrae%Lumbar vertebrae%Fracture fixation,internal
目的 设计一种胸腰椎骨折后路微创器械,并评估该器械在术中辅助经皮置入椎弓根螺钉治疗胸腰椎骨折的应用价值.方法 设计胸腰椎骨折后路微创器械,并于2004年12月至2006年11月采用该器械术中辅助经皮置入椎弓根螺钉固定治疗17例胸腰椎骨折患者,其中男11例,女6例;年龄27～56岁,平均39.1岁;损伤节段:T112例,T1266例,L136例,L33例.记录并分析手术时间、出血量、伤椎前缘高度比值、后凸Cobb角的恢复情况、复位丢失率,并观察并发症发生情况.结果 本组手术时间平均(110±18)min,出血量平均(120±68)mL.术后所有患者随访14～22个月,平均19个月.伤椎前缘高度比值从术前平均52.1%±2.9%恢复至术后95.2%±0.4%,差异有统计学意义(P<0.05);后凸Cobb角从术前15.9°±1.6恢复至术后5.9°±0.9°,差异有统计学意义(P<0.05);末次随访复位高度丢失率平均12.1%±0.2%,伤椎前缘高度比值和后凸 Cobb角与术后比较差异无统计学意义(P>0.05).随访期间未见感染、腰背酸痛病例,未见术后断钉、断棒等并发症.结论 自行研制的胸腰椎骨折后路微创器械,手术应用效果良好,具有临床推广应用价值.
目的 設計一種胸腰椎骨摺後路微創器械,併評估該器械在術中輔助經皮置入椎弓根螺釘治療胸腰椎骨摺的應用價值.方法 設計胸腰椎骨摺後路微創器械,併于2004年12月至2006年11月採用該器械術中輔助經皮置入椎弓根螺釘固定治療17例胸腰椎骨摺患者,其中男11例,女6例;年齡27～56歲,平均39.1歲;損傷節段:T112例,T1266例,L136例,L33例.記錄併分析手術時間、齣血量、傷椎前緣高度比值、後凸Cobb角的恢複情況、複位丟失率,併觀察併髮癥髮生情況.結果 本組手術時間平均(110±18)min,齣血量平均(120±68)mL.術後所有患者隨訪14～22箇月,平均19箇月.傷椎前緣高度比值從術前平均52.1%±2.9%恢複至術後95.2%±0.4%,差異有統計學意義(P<0.05);後凸Cobb角從術前15.9°±1.6恢複至術後5.9°±0.9°,差異有統計學意義(P<0.05);末次隨訪複位高度丟失率平均12.1%±0.2%,傷椎前緣高度比值和後凸 Cobb角與術後比較差異無統計學意義(P>0.05).隨訪期間未見感染、腰揹痠痛病例,未見術後斷釘、斷棒等併髮癥.結論 自行研製的胸腰椎骨摺後路微創器械,手術應用效果良好,具有臨床推廣應用價值.
목적 설계일충흉요추골절후로미창기계,병평고해기계재술중보조경피치입추궁근라정치료흉요추골절적응용개치.방법 설계흉요추골절후로미창기계,병우2004년12월지2006년11월채용해기계술중보조경피치입추궁근라정고정치료17례흉요추골절환자,기중남11례,녀6례;년령27～56세,평균39.1세;손상절단:T112례,T1266례,L136례,L33례.기록병분석수술시간、출혈량、상추전연고도비치、후철Cobb각적회복정황、복위주실솔,병관찰병발증발생정황.결과 본조수술시간평균(110±18)min,출혈량평균(120±68)mL.술후소유환자수방14～22개월,평균19개월.상추전연고도비치종술전평균52.1%±2.9%회복지술후95.2%±0.4%,차이유통계학의의(P<0.05);후철Cobb각종술전15.9°±1.6회복지술후5.9°±0.9°,차이유통계학의의(P<0.05);말차수방복위고도주실솔평균12.1%±0.2%,상추전연고도비치화후철 Cobb각여술후비교차이무통계학의의(P>0.05).수방기간미견감염、요배산통병례,미견술후단정、단봉등병발증.결론 자행연제적흉요추골절후로미창기계,수술응용효과량호,구유림상추엄응용개치.
Objective To evaluate a self-designed minimally invasive device which can facilitate the posterior percutaneous pedicle screw fixation of the thoraeolumbar fractures. Methods From December 2004 to November 2006.17 patients with thoracolumbar fractures were treated by posterior pereutaneous pedicle screw fixation.using a self-designed minimally invasive device to facilitate the operation.We recorded and analyzed the operation time,bleeding volume,anterior border height of the injured vertebra,Cobb angle of kyphosis,late loss of correction,and complications. Results All the patients were followed up for a mean of 19 months(14 to 22 months).The mean anterior border height of the injured vertebra increased from 52.1%±2.9%preoperatively to 95.2%±0.4% postoperatively,with a significant difference(P<0.05).The mean Cobb angle was corrected from 15.9°±1.6°preoperatively to 5.9°±0.9°postoperatively,with a significant difference(P<0.05).,The mean late losss of correction was 12.1%±0.2%,the mean operation time was(110±18)min and the mean bleeding volume was(120±68)mL. Conclusion Since the self-designed minimally invasive device can greatly facilitate the posterior percutaneous pedicle screw fixation of the thoracolumbar fractures.it should be recommended for a wider clinical use.
