中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2014年
2期
113-116
,共4页
脊柱骨折%胸椎%腰椎%骨折固定%撬拨复位
脊柱骨摺%胸椎%腰椎%骨摺固定%撬撥複位
척주골절%흉추%요추%골절고정%효발복위
Spinal fractures%Thoracic vertebrae%Lumbar vertebrae%Fracture fixation%Poking reduction
背景：胸腰椎骨折伤椎复位效果经常不满意，手术方式仍有争议。<br> 目的：探讨经伤椎椎弓根置钉撬拨复位联合短节段内固定治疗胸腰椎骨折的疗效。<br> 方法：回顾性分析2010年8月至2012年10月40例行经伤椎椎弓根置钉撬拨复位短节段内固定的单节段胸腰椎骨折患者的临床资料。其中男32例，女8例，年龄23~63岁，平均45岁。比较患者手术前后伤椎前后缘高度比（伤椎前后缘高度与相邻上、下椎体前后缘高度平均值之比）、矢状面Cobb角、神经功能，进行疗效评价。<br> 结果：患者随访6~18个月，平均12个月，无内固定失败发生。术前有神经功能不全损害的4例患者获得完全恢复。患者矢状面Cobb角由术前平均17.4°±8.0°恢复到术后2.1°±5.7°（P=0.000）；伤椎前缘平均高度比由术前52.7%±13.2%恢复到术后91.2%±9.4%（P=0.000）；伤椎后缘平均高度比由术前92.6%±8.3%恢复到术后98.5%±2.9%（P=0.005）。<br> 结论：对于单节段胸腰椎骨折患者，伤椎椎弓根置钉撬拨复位联合短节段内固定的治疗方法是安全、有效的。
揹景：胸腰椎骨摺傷椎複位效果經常不滿意，手術方式仍有爭議。<br> 目的：探討經傷椎椎弓根置釘撬撥複位聯閤短節段內固定治療胸腰椎骨摺的療效。<br> 方法：迴顧性分析2010年8月至2012年10月40例行經傷椎椎弓根置釘撬撥複位短節段內固定的單節段胸腰椎骨摺患者的臨床資料。其中男32例，女8例，年齡23~63歲，平均45歲。比較患者手術前後傷椎前後緣高度比（傷椎前後緣高度與相鄰上、下椎體前後緣高度平均值之比）、矢狀麵Cobb角、神經功能，進行療效評價。<br> 結果：患者隨訪6~18箇月，平均12箇月，無內固定失敗髮生。術前有神經功能不全損害的4例患者穫得完全恢複。患者矢狀麵Cobb角由術前平均17.4°±8.0°恢複到術後2.1°±5.7°（P=0.000）；傷椎前緣平均高度比由術前52.7%±13.2%恢複到術後91.2%±9.4%（P=0.000）；傷椎後緣平均高度比由術前92.6%±8.3%恢複到術後98.5%±2.9%（P=0.005）。<br> 結論：對于單節段胸腰椎骨摺患者，傷椎椎弓根置釘撬撥複位聯閤短節段內固定的治療方法是安全、有效的。
배경：흉요추골절상추복위효과경상불만의，수술방식잉유쟁의。<br> 목적：탐토경상추추궁근치정효발복위연합단절단내고정치료흉요추골절적료효。<br> 방법：회고성분석2010년8월지2012년10월40례행경상추추궁근치정효발복위단절단내고정적단절단흉요추골절환자적림상자료。기중남32례，녀8례，년령23~63세，평균45세。비교환자수술전후상추전후연고도비（상추전후연고도여상린상、하추체전후연고도평균치지비）、시상면Cobb각、신경공능，진행료효평개。<br> 결과：환자수방6~18개월，평균12개월，무내고정실패발생。술전유신경공능불전손해적4례환자획득완전회복。환자시상면Cobb각유술전평균17.4°±8.0°회복도술후2.1°±5.7°（P=0.000）；상추전연평균고도비유술전52.7%±13.2%회복도술후91.2%±9.4%（P=0.000）；상추후연평균고도비유술전92.6%±8.3%회복도술후98.5%±2.9%（P=0.005）。<br> 결론：대우단절단흉요추골절환자，상추추궁근치정효발복위연합단절단내고정적치료방법시안전、유효적。
Background:The reduction of fractured thoracic and lumbar vertebra is often unsatisfactory, and the appropriate operation is still controversial. <br> Objective:To evaluate the efficacy of pedicle instrumentation and poking reduction through the pedicle of fractured verte-bra in combination with short segment of pedicle screw fixation in the treatment of thoracolumbar fracture. <br> Methods:Forty patients with single segment thoracolumbar fracture received pedicle instrumentation and poking reduction through the pedicle of fractured vertebra in combination with short segment of pedicle screw fixation from August 2010 to October 2012. There were 32 males and 8 females with an average age of 45 years (range from 23 to 63 years). The anterior and posterior vertebral body height, sagittal Cobb angle and nervous function were assessed before and after surgery. <br> Results:The mean follow-up duration was 12 months (range, 6-18 months). There was no internal fixation failure. Four pa-tients who had an associated neurologic deficit were completely recovered. The sagittal Cobb angle decreased from 17.4° ± 8.0° preoperatively to 2.1°±5.7° postoperatively (P=0.000). The mean ratio of injured anterior vertebral body height to nor-mal vertebra increased from 52.7%±13.2%preoperatively to 91.2%±9.4%postoperatively (P=0.000). The mean ratio of in-jured posterior vertebral body height to normal vertebra increased from 92.6%±8.3%preoperatively to 98.5%±2.9%postop-eratively (P=0.005). <br> Conclusions:Pedicle instrumentation and poking reduction through fractured vertebra in combination with short segment of pedicle screw fixation is safe and effective for single segment thoracolumbar fracture.
