中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
9期
1642-1646
,共5页
脊柱骨折%内固定器%短节段
脊柱骨摺%內固定器%短節段
척주골절%내고정기%단절단
Spinal fractures%Internal fixators%Short segment
目的：评价短节段伤椎内固定技术在治疗胸腰段单椎体骨折中的临床效果。方法选取本院2004年7月至2008年5月胸腰椎骨折患者48例，其中男31例，女17例；年龄23～55岁，平均39岁，所有病例CT显示均有椎管内占位，其中16例有不同程度的下肢症状。随机分为试验组和对照组。其中试验组33例（男22例，女11例），行短节段内固定技术固定骨折椎体，对照组15例（男9例，女6例），行单节段四钉两棒内固定技术固定骨折椎体，所有患者均得到随访，以伤椎前缘压缩程度、Cobb's 角及中柱突入椎管的程度为指标来评价两组的手术效果，所有病例均随访至术后1年。结果试验组无论在术后1周的即时复位还是术后1年复位丢失上都要优于对照组，两者相比有统计学意义（P＜0.01）。结论短节段伤椎内固定技术治疗胸腰段椎体骨折无论在骨折复位还是维持术后复位丢失方面都要优于单节段四钉两棒内固定方式，而且短节段伤椎内固定技术也较少发生内固定物折断、折弯及椎弓根钉松动、拔出等内固定失败情况。
目的：評價短節段傷椎內固定技術在治療胸腰段單椎體骨摺中的臨床效果。方法選取本院2004年7月至2008年5月胸腰椎骨摺患者48例，其中男31例，女17例；年齡23～55歲，平均39歲，所有病例CT顯示均有椎管內佔位，其中16例有不同程度的下肢癥狀。隨機分為試驗組和對照組。其中試驗組33例（男22例，女11例），行短節段內固定技術固定骨摺椎體，對照組15例（男9例，女6例），行單節段四釘兩棒內固定技術固定骨摺椎體，所有患者均得到隨訪，以傷椎前緣壓縮程度、Cobb's 角及中柱突入椎管的程度為指標來評價兩組的手術效果，所有病例均隨訪至術後1年。結果試驗組無論在術後1週的即時複位還是術後1年複位丟失上都要優于對照組，兩者相比有統計學意義（P＜0.01）。結論短節段傷椎內固定技術治療胸腰段椎體骨摺無論在骨摺複位還是維持術後複位丟失方麵都要優于單節段四釘兩棒內固定方式，而且短節段傷椎內固定技術也較少髮生內固定物摺斷、摺彎及椎弓根釘鬆動、拔齣等內固定失敗情況。
목적：평개단절단상추내고정기술재치료흉요단단추체골절중적림상효과。방법선취본원2004년7월지2008년5월흉요추골절환자48례，기중남31례，녀17례；년령23～55세，평균39세，소유병례CT현시균유추관내점위，기중16례유불동정도적하지증상。수궤분위시험조화대조조。기중시험조33례（남22례，녀11례），행단절단내고정기술고정골절추체，대조조15례（남9례，녀6례），행단절단사정량봉내고정기술고정골절추체，소유환자균득도수방，이상추전연압축정도、Cobb's 각급중주돌입추관적정도위지표래평개량조적수술효과，소유병례균수방지술후1년。결과시험조무론재술후1주적즉시복위환시술후1년복위주실상도요우우대조조，량자상비유통계학의의（P＜0.01）。결론단절단상추내고정기술치료흉요단추체골절무론재골절복위환시유지술후복위주실방면도요우우단절단사정량봉내고정방식，이차단절단상추내고정기술야교소발생내고정물절단、절만급추궁근정송동、발출등내고정실패정황。
Objective To evaluate the clinical effect of posterior short segment and fractured vertebra fixation in creating thoracolumbar fracture. Methods 48 patients with thoracolumbar spine fracture were included of our hospital between July 2004 and May 2008, 33 patients were men, 17 patients were women, range of age was from 23 to 55, average was 39. CT displays that all patients had outstanding in vertebral canal, and there were 16 patients having different lower limb symptom,dividing them into experimental group and control group at random. There were 33 patients (man 22, woman 11) in experimental group underwent internal fixation of short segment and fractured vertebra, and control group was 15 patients(man 9, woman 6) underwent posterior monosegment fixation. All cases were followed-up for one year. To assess the clinical effect of two group by compression degree of anterior border of fractural vertebral body, cobb's angle and the degree of outstanding. Results Experimental group was better than control group not only in immediately reset behind one week but also the lost of reset behind one year, the difference had statistical significance(P<0.01). Conclusion Short segment and fractured vertebra fixation is better in creating thoracolumbar spine fracture than posterior monosegment fixation not only in immediately reset but also the lost of reset, and the former has less risk, for instance the break of internal instrument and the pulling out of vertebral arch pedical nail.
