中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
10期
986-989
,共4页
脊柱骨折%胸椎%腰椎%骨折固定术,内
脊柱骨摺%胸椎%腰椎%骨摺固定術,內
척주골절%흉추%요추%골절고정술,내
Spinal fractures%Thoracic vertebrae%Lumbar vertebrae%Fracture fixation,internal
目的 对比短节段椎弓根螺钉系统固定及附加伤椎固定治疗胸腰椎爆裂骨折的效果. 方法 选取2008年6月-2011年6月收治的胸腰椎爆裂骨折患者56例,其中男40例,女16例;年龄25 ～ 60岁,平均32.8岁.致伤原因:交通伤24例,高处坠落伤19例,重物压砸伤13例.骨折节段:T116例,T1214例,L116例,L212例,L3 5例,L43例.根据固定方式分为:跨伤椎短节段椎弓根螺钉固定(A组)30例,跨伤椎短节段椎弓根螺钉固定附加伤椎椎弓根固定(B组)26例.术前、术后1周、术后1年对两组伤椎前缘高度比、矢状面Cobb角、美国脊髓损伤协会(American Spinal Injury Association,ASIA)神经功能分级等指标进行比较分析,评价手术疗效.结果 术前、术后1周伤椎前缘高度比及矢状面Cobb角两组间比较,差异均无统计学意义.术后1年A组伤椎前缘高度比及矢状面Cobb角分别为(87.2±6.9)％、(7.6±3.2)°,B组分别为(93.3±5.7)％、(5.7±1.9)°(P均＜0.05).两组术后1年神经功能ASIA分级比较差异无统计学意义. 结论 短节段椎弓根螺钉系统附加伤椎固定是治疗胸腰椎爆裂骨折的一种有效方法.
目的 對比短節段椎弓根螺釘繫統固定及附加傷椎固定治療胸腰椎爆裂骨摺的效果. 方法 選取2008年6月-2011年6月收治的胸腰椎爆裂骨摺患者56例,其中男40例,女16例;年齡25 ～ 60歲,平均32.8歲.緻傷原因:交通傷24例,高處墜落傷19例,重物壓砸傷13例.骨摺節段:T116例,T1214例,L116例,L212例,L3 5例,L43例.根據固定方式分為:跨傷椎短節段椎弓根螺釘固定(A組)30例,跨傷椎短節段椎弓根螺釘固定附加傷椎椎弓根固定(B組)26例.術前、術後1週、術後1年對兩組傷椎前緣高度比、矢狀麵Cobb角、美國脊髓損傷協會(American Spinal Injury Association,ASIA)神經功能分級等指標進行比較分析,評價手術療效.結果 術前、術後1週傷椎前緣高度比及矢狀麵Cobb角兩組間比較,差異均無統計學意義.術後1年A組傷椎前緣高度比及矢狀麵Cobb角分彆為(87.2±6.9)％、(7.6±3.2)°,B組分彆為(93.3±5.7)％、(5.7±1.9)°(P均＜0.05).兩組術後1年神經功能ASIA分級比較差異無統計學意義. 結論 短節段椎弓根螺釘繫統附加傷椎固定是治療胸腰椎爆裂骨摺的一種有效方法.
목적 대비단절단추궁근라정계통고정급부가상추고정치료흉요추폭렬골절적효과. 방법 선취2008년6월-2011년6월수치적흉요추폭렬골절환자56례,기중남40례,녀16례;년령25 ～ 60세,평균32.8세.치상원인:교통상24례,고처추락상19례,중물압잡상13례.골절절단:T116례,T1214례,L116례,L212례,L3 5례,L43례.근거고정방식분위:과상추단절단추궁근라정고정(A조)30례,과상추단절단추궁근라정고정부가상추추궁근고정(B조)26례.술전、술후1주、술후1년대량조상추전연고도비、시상면Cobb각、미국척수손상협회(American Spinal Injury Association,ASIA)신경공능분급등지표진행비교분석,평개수술료효.결과 술전、술후1주상추전연고도비급시상면Cobb각량조간비교,차이균무통계학의의.술후1년A조상추전연고도비급시상면Cobb각분별위(87.2±6.9)％、(7.6±3.2)°,B조분별위(93.3±5.7)％、(5.7±1.9)°(P균＜0.05).량조술후1년신경공능ASIA분급비교차이무통계학의의. 결론 단절단추궁근라정계통부가상추고정시치료흉요추폭렬골절적일충유효방법.
Objective To evaluate the result of short-segment pedicle screw instrumentation plus pedicle screws inserted into the injury level for treatment of thoracolumbar burst fracture.Methods Fifty-six cases of thoracolumbar burst fracture treated from June 2008 to June 2011 were reviewed.There were 40 males and 16 females at mean age of 32.8 years (range,25-60 years).Twenty-four cases were injured from traffic accidents,19 cases from fall from the height,and 13 cases from fall of heavy objects.Fractured segments were T11 in 6 cases,T12 in 14 cases,L1 in 16 cases,L2 in 12 cases,L3in 5 cases,and L4 in 3 cases.Thirty cases underwent short-segment pedicle screw fixation through the level above the fracture to level below the fracture (Group A).Apart from this,26 cases were treated with additional transpedicular fixation at the fractured level (Group B).Anterior vertebral height ratio,sagittal Cobb' s angle,neurologic performance as evaluated by American Spinal Injury Association (ASIA) scale were assessed before operation,one week after operation,and one year after operation.Results Anterior vertebral height ratio and Cobb' s angle revealed no significant differences between the two groups before operation and one week after operation.At postoperative one year,anterior vertebral height ratio and sagittal Cobb' s angle were (87.2 ± 6.9)％ and (7.6 ± 3.2)°in Group A with significant differences from (93.3 5.7)％ and (5.7 ± 1.9) ° in Group B (P ＜ 0.05),but there was no statistical difference in ASIA scale of neurologic performance.Conclusion Short-segment pedicle screw instrumentation with stabilization at the level of fracture is an effective treatment for thoracolumbar burst fracture.
