CAJ | 학술논문

背景:胸腰椎骨折治疗方法众多,但是对于无神经症状的爆裂型骨折,采用简单的手术方法治疗,是否在减少创伤的同时能够取得较好的疗效,从而避免手术的扩大化尚不清楚.目的:观察采用单纯后路短节段椎弓根螺钉系统置入治疗无神经症状的单节段胸腰椎爆裂型骨折的疗效.方法:选择2003-09/2008 01苏州大学附属第一医院骨科收治的无神经症状单节段胸腰椎爆裂型骨折患者186例,男152例,女34例,年龄18-65岁.均采用单纯后路短节段椎弓根螺钉内固定置入治疗,椎管内骨块占位采用间接复位.于置入前、置入后及置入后1年余取内固定前摄以伤椎为中心的X射线正侧位片和CT,对X射线平片和CT进行测量,统计伤椎前缘高度、伤椎横截面积内骨块的占有率.结果与结论:伤椎前缘置入前高度平均为正常的42%,术后为98%,内固定取出术前伤椎前缘高度为正常高度的98%.伤椎横截面积内骨块占有率,术前平均为34%,术后平均为13%,内固定取出术前为8%.提示应用后路短节段椎弓根螺钉系统治疗无神经症状的胸腰椎爆裂型骨折,能够提供脊柱足够的稳定性,有效恢复椎体高度、生理弧度和椎管容积.
배경:흉요추골절치료방법음다,단시대우무신경증상적폭렬형골절,채용간단적수술방법치료,시부재감소창상적동시능구취득교호적료효,종이피면수술적확대화상불청초.목적:관찰채용단순후로단절단추궁근라정계통치입치료무신경증상적단절단흉요추폭렬형골절적료효.방법:선택2003-09/2008 01소주대학부속제일의원골과수치적무신경증상단절단흉요추폭렬형골절환자186례,남152례,녀34례,년령18-65세.균채용단순후로단절단추궁근라정내고정치입치료,추관내골괴점위채용간접복위.우치입전、치입후급치입후1년여취내고정전섭이상추위중심적X사선정측위편화CT,대X사선평편화CT진행측량,통계상추전연고도、상추횡절면적내골괴적점유솔.결과여결론:상추전연치입전고도평균위정상적42%,술후위98%,내고정취출술전상추전연고도위정상고도적98%.상추횡절면적내골괴점유솔,술전평균위34%,술후평균위13%,내고정취출술전위8%.제시응용후로단절단추궁근라정계통치료무신경증상적흉요추폭렬형골절,능구제공척주족구적은정성,유효회복추체고도、생리호도화추관용적.
BACKGROUND:There are many methods to treat thoracolumbar fractures However,it remains unclear whether a simple operation to treat a thoracolumbar burst fracture can decrease the trauma and obtain better effect to avoid the enlargement of operation.OBJECTIVE:To investigate the clinical outcome of posterior short-segmental transpedicular screw system internal fixation in treatment of single-level thoracolumbar burst fracture without nerologic deficit.METHODS:A total of 186 patients with single.level thoracolumbar burst fracture but without nerologic deficit treated in the First Affiliated Hospital of Soochow University between September 2003 and January 2008,including 152 males and 34 females,aged18 10 65 years.were treated by posterior pedicle screw The intraspinal bone fragments were treated with indirect decompression.All patients were checked with radiography and CT scan before/after operation as well as before implant removal.The correction of anterior vertebral body height and the ratio of bone fragment to cross section area of spinal canal were measured.RESULT AND CONCLUSION:Compared with normal.the anterior vertebral body height was 42%before operation,98%after operation,and 98%before implant removal The ratio of bone fragment to cross section area of spinal canal was 34%before operation,13%after operation.and 8%before implant removal.Internal posterior short-segmental transpedicular screw fixation treating single-level thoracolumbar burst fracture without nerologic deficit can obtain stability of spinal column,and it is beneficial to recovery of body height,physiologic postu ral contour and canal volumn .