CAJ | 학술논문

目的评估新型前路复合板-棒系统治疗急性胸腰椎爆裂骨折合并神经损伤的安全性和有效性. 方法回顾性研究采用新型前路复合板-棒系统前路手术、植骨、固定治疗的84例急性胸腰椎爆裂骨折合并神经损伤患者.其中男61例,女23例;年龄19 ～ 53岁,平均31.4岁.致伤原因:高处坠落伤67例,交通伤13例,其他4例.骨折部位:T1119例,T1222例,L125例,L218例.所有患者均接受影像学和神经功能评价,并观察视觉模拟评分(visual analogue scale,VAS)、融合情况、椎管占位以及后凸角矫正丢失等情况. 结果所有患者随访3～5个月,均获得骨性融合,无器械相关假关节或血管损伤.椎管占位从术前70％改善至术后2％.节段后凸Cobb角术前平均为27.9°,术后即刻平均为7.4°,平均矫正20.5°.84例最终随访时神经功能改善至少1级.VAS从术前平均7.3分改善至术后平均2.9分. 结论新型前路复合板-棒系统是治疗急性胸腰椎爆裂骨折安全有效的方法.
목적 평고신형전로복합판-봉계통치료급성흉요추폭렬골절합병신경손상적안전성화유효성. 방법 회고성연구채용신형전로복합판-봉계통전로수술、식골、고정치료적84례급성흉요추폭렬골절합병신경손상환자.기중남61례,녀23례;년령19 ～ 53세,평균31.4세.치상원인:고처추락상67례,교통상13례,기타4례.골절부위:T1119례,T1222례,L125례,L218례.소유환자균접수영상학화신경공능평개,병관찰시각모의평분(visual analogue scale,VAS)、융합정황、추관점위이급후철각교정주실등정황. 결과 소유환자수방3～5개월,균획득골성융합,무기계상관가관절혹혈관손상.추관점위종술전70％개선지술후2％.절단후철Cobb각술전평균위27.9°,술후즉각평균위7.4°,평균교정20.5°.84례최종수방시신경공능개선지소1급.VAS종술전평균7.3분개선지술후평균2.9분. 결론 신형전로복합판-봉계통시치료급성흉요추폭렬골절안전유효적방법.
Objective To evaluate the safety and efficacy of the newly combined anterior platerod system in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.Methods A retrospective study was carried out on 84 consecutive patients with acute thoracolumbar burst fracture combined with neurologic deficits treated by anterior surgery,bone fusion,and internal fixation with the new plate-rod system.There were 61 males and 23 females with a mean age of 31.4 years (range,19-53 years).Primary pathogenesis was high falls in 67 patients,traffic accidents in 13 patients and others in 4 patients.Fractured segments included T11 in 19 patients,T12 in 22,L1 in 25,and L2 in 18.Visual analogue scale (VAS),spinal canal encroachment,and loss of kyphosis correction were measured for all patients to evaluate radiologic and neurological outcomes.Results Bony union occurred in all patients at the 3-5 months of follow-up.There was no pseudarthrosis or vascular complications related to the fixation device.Percentage of canal encroachment decreased from preoperative 70％ to postoperative 2％.Mean segmental kyphotic angle measured 27.9 ° before operation and 7.4 ° after operation,with a mean correction of 20.5°.All patients demonstrated at least one grade of neurological improvement at final follow-up.Mean VAS was improved significantly from preoperative 7.3 points to postoperative 2.9 points.Conclusion The new anterior plate-rod system is safe and effective in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.