中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
11期
1492-1494
,共3页
脊柱骨折%骨重建%固定装置,内
脊柱骨摺%骨重建%固定裝置,內
척주골절%골중건%고정장치,내
Spinall fractures%Bone remodeling%Fixation devices,internal
目的 探讨后正中小切口前后联合内固定椎体重建术治疗不稳定性爆裂性腰椎骨折的临床疗效.方法 回顾性分析采取后正中小切口前后联合内固定椎体重建术治疗不稳定性爆裂性腰椎骨折40例患者的临床资料,采用自身对照比较手术前后脊柱形态、功能恢复情况(JOA评分),并予1～2年随访,观察远期疗效.结果 40例患者术后椎体高度恢复95%～100%,CT扫描未见椎管内骨块残留,后凸畸形纠正率100%.所有患者予1～2年随访,未见内固定松动、断裂和失效.手术前、后脊柱Cobb角[(20.1±3.3)°与(1.8±0.8)°]、伤椎后凸角[(15.2±2.9)°与(0.7±0.1)°]、伤椎前缘高度[(67.5±6.4)%与(96.4 ±1.3)%]、矢状位指数[(66.8±7.3)%与(95.6 ±2.3)%]等差异均有统计学意义(t=34.085、31.604、27.988、23.798,均P＜0.05);手术前、后JOA总评分[(5.47±1.28)分与(23.52 ±3.35)分]差异有统计学意义(t=31.834,P＜0.05),随访时与术后JOA评分差异均无统计学意义(均P＞0.05).结论 小切口前后联合内固定椎体重建术治疗不稳定性爆裂性腰椎骨折效果显著,值得临床推广应用.
目的 探討後正中小切口前後聯閤內固定椎體重建術治療不穩定性爆裂性腰椎骨摺的臨床療效.方法 迴顧性分析採取後正中小切口前後聯閤內固定椎體重建術治療不穩定性爆裂性腰椎骨摺40例患者的臨床資料,採用自身對照比較手術前後脊柱形態、功能恢複情況(JOA評分),併予1～2年隨訪,觀察遠期療效.結果 40例患者術後椎體高度恢複95%～100%,CT掃描未見椎管內骨塊殘留,後凸畸形糾正率100%.所有患者予1～2年隨訪,未見內固定鬆動、斷裂和失效.手術前、後脊柱Cobb角[(20.1±3.3)°與(1.8±0.8)°]、傷椎後凸角[(15.2±2.9)°與(0.7±0.1)°]、傷椎前緣高度[(67.5±6.4)%與(96.4 ±1.3)%]、矢狀位指數[(66.8±7.3)%與(95.6 ±2.3)%]等差異均有統計學意義(t=34.085、31.604、27.988、23.798,均P＜0.05);手術前、後JOA總評分[(5.47±1.28)分與(23.52 ±3.35)分]差異有統計學意義(t=31.834,P＜0.05),隨訪時與術後JOA評分差異均無統計學意義(均P＞0.05).結論 小切口前後聯閤內固定椎體重建術治療不穩定性爆裂性腰椎骨摺效果顯著,值得臨床推廣應用.
목적 탐토후정중소절구전후연합내고정추체중건술치료불은정성폭렬성요추골절적림상료효.방법 회고성분석채취후정중소절구전후연합내고정추체중건술치료불은정성폭렬성요추골절40례환자적림상자료,채용자신대조비교수술전후척주형태、공능회복정황(JOA평분),병여1～2년수방,관찰원기료효.결과 40례환자술후추체고도회복95%～100%,CT소묘미견추관내골괴잔류,후철기형규정솔100%.소유환자여1～2년수방,미견내고정송동、단렬화실효.수술전、후척주Cobb각[(20.1±3.3)°여(1.8±0.8)°]、상추후철각[(15.2±2.9)°여(0.7±0.1)°]、상추전연고도[(67.5±6.4)%여(96.4 ±1.3)%]、시상위지수[(66.8±7.3)%여(95.6 ±2.3)%]등차이균유통계학의의(t=34.085、31.604、27.988、23.798,균P＜0.05);수술전、후JOA총평분[(5.47±1.28)분여(23.52 ±3.35)분]차이유통계학의의(t=31.834,P＜0.05),수방시여술후JOA평분차이균무통계학의의(균P＞0.05).결론 소절구전후연합내고정추체중건술치료불은정성폭렬성요추골절효과현저,치득림상추엄응용.
Objective To explore the clinical effect of anterior combined with posterior fixation and vertebra reconstruction for unstable lumbar burst fracture via small incision alone posterior median line.Methods This study was based on 40 patients suffering from unstable lumbar burst fracture,who underwent anterior combined with posterior fixation and vertebra reconstruction.All the patients were followed up for 1～2 years.The shape and the function of spinal column were estimated in preoperative stage,postoperative stage and the duration of following.The data in the formal 3 stages were compared.Results Between the preoperative and postoperative data,there were statistically significant differences in the Cobb's angle,angle of kyphosis,anterior height of the fracture vertebral body,sagittal index and JOA scores(t=34.085,31.604,27.988,23.798,31.834,all P＜0.05).But no similar result was detected between the postoperative data and the data during the following(P＞0.05).Conclusion Anterior combined with posterior fixation and vertebra reconstruction via small incision had a significant effect in unstable lumbar burst fracture,and it was worthy of further study and clinical popularization.
