CAJ | 학술논문

[目的]探讨经椎弓根行椎体楔形截骨术（PSO ）治疗陈旧性胸腰椎压缩骨折伴后凸畸形疗效。[方法]选择经椎弓根行椎体楔形接骨术治疗的陈旧性胸腰椎压缩骨折伴后凸畸形患者19例，比较术前、术后Cobb角度变化和神经功能Frankel分级。[结果]矫正后术后3个月胸腰椎后凸Cobb角为10．3°±2．6°，与术前46°±11．3°比较有统计学差异（ t ＝3．886， P ＜0．01），矫正率为77．6％（36/46）；术后24个月随访胸腰椎后凸Cobb角为12．6°±1．8°，与术前比较有统计学差异（ t ＝3．742，P ＜0．01），与术后3个月比较无统计学差异（ t ＝0．576，P ＞0．05），矫正丢失率5．0％（2/36）。手术后患者神经功能Frankel分级显示：3例A级2例改善到C级，5例B级中1例改善到C级，1例改善到D级，4例C级中1例改善E级，5例D级中1例改善到E级。[结论]经椎弓根行椎体楔形截骨术治疗陈旧性胸腰椎压缩骨折伴后凸畸形，疗效满意，值得临床推广应用。
[목적]탐토경추궁근행추체설형절골술（PSO ）치료진구성흉요추압축골절반후철기형료효。[방법]선택경추궁근행추체설형접골술치료적진구성흉요추압축골절반후철기형환자19례，비교술전、술후Cobb각도변화화신경공능Frankel분급。[결과]교정후술후3개월흉요추후철Cobb각위10．3°±2．6°，여술전46°±11．3°비교유통계학차이（ t ＝3．886， P ＜0．01），교정솔위77．6％（36/46）；술후24개월수방흉요추후철Cobb각위12．6°±1．8°，여술전비교유통계학차이（ t ＝3．742，P ＜0．01），여술후3개월비교무통계학차이（ t ＝0．576，P ＞0．05），교정주실솔5．0％（2/36）。수술후환자신경공능Frankel분급현시：3례A급2례개선도C급，5례B급중1례개선도C급，1례개선도D급，4례C급중1례개선E급，5례D급중1례개선도E급。[결론]경추궁근행추체설형절골술치료진구성흉요추압축골절반후철기형，료효만의，치득림상추엄응용。
[Objective] To explore the efficacy of transpedicular vertebral wedge osteosynthesis (PSO) for the treatment of old thoracolumbar compression fracture with kyphosis .[Methods]A total of 19 patients with old thoracolumbar vertebral compression and kyphosis undergoing PSO were chosen .The change of Cobb an-gle and Frankel classification of nerve function before and after operation were compared .[Results]Compared with before operation[(46 ± 11 .3)°] ,the Cobb angle of thoracolumbar kyphosis after correction for 3 months was (10 .3 ± 2 .6)° ,and there was significant difference( t =3 .886 ,P <0 .01) ,and the correction rate was 77 .6% (36/46) .After follow-up for 24 months ,the Cobb angle of thoracolumbar kyphosis was (12 .6 ± 1 . 8)° ,and there was significant difference between before treatment and after follow up for 24 months( t =3 . 742 ,P <0 .01) ,but there was no significant difference between after follow up for 24 hours and 3 months af-ter operation( t=0 .576 ,P>0 .05) .The correction loss rate was 5 .0% (2/36) .After the operation ,Frankel classification of nerve function showed that 3 patients were improved from grade A to grade C ,and 1 patient a-mong 5 patients was improved from grade B to grade C ,and 1 patient of them was improved from grade B to grade D ,and 1 patient among 4 patients was improved from grade C to grade E ,and 1 patient among 5 pa-tients was improved from grade D to grade E .[Conclusion] PSO for the treatment of old thoracolumbar com-pression fracture with kyphosis has satisfactory effect ,so it is worthy of clinical promotion .