CAJ | 학술논문

背景：对于强直性脊柱炎合并胸腰椎骨折患者，采用传统方法行短节段经椎弓根内固定或前路钉板或钉棒系统固定由于其骨质疏松明显，螺钉抗拔出力较差，治疗后容易出现内固定松动。 　　目的：探讨多节段经椎弓根内固定治疗强直性脊柱炎合并胸腰椎骨折的效果。 　　方法：选择2009年1月至2012年12月中山大学附属梅州医院骨科收治的强直性脊柱炎合并胸腰椎骨折患者11例，行后路复位多节段椎弓钉内固定，其中6例采用经伤椎椎弓根固定。 　　结果与结论：11例患者均获随访，随访时间13-36个月。所有患者影像学显示均骨性愈合，未见内固定松动断裂现象。3例脊髓神经损伤按Frankel分级由C级恢复至E级。JOA评分评估腰背痛改善率为100%。结果显示经后路复位多节段椎弓根钉置入治疗强直性脊柱炎合并胸腰椎骨折，可获得坚强内固定，骨折愈合良好。
배경：대우강직성척주염합병흉요추골절환자，채용전통방법행단절단경추궁근내고정혹전로정판혹정봉계통고정유우기골질소송명현，라정항발출력교차，치료후용역출현내고정송동。 　　목적：탐토다절단경추궁근내고정치료강직성척주염합병흉요추골절적효과。 　　방법：선택2009년1월지2012년12월중산대학부속매주의원골과수치적강직성척주염합병흉요추골절환자11례，행후로복위다절단추궁정내고정，기중6례채용경상추추궁근고정。 　　결과여결론：11례환자균획수방，수방시간13-36개월。소유환자영상학현시균골성유합，미견내고정송동단렬현상。3례척수신경손상안Frankel분급유C급회복지E급。JOA평분평고요배통개선솔위100%。결과현시경후로복위다절단추궁근정치입치료강직성척주염합병흉요추골절，가획득견강내고정，골절유합량호。
BACKGROUND:Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pul-out strength in patients with thoracolumbar fracture with ankylosing spondylitis. OBJECTIVE:To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis. METHODS:Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. Al the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra. RESULTS AND CONCLUSION:Al of the 11 patients were fol owed up for 13 to 36 months. Solid bone healing was achieved in al of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of spinal cord injury achieved Frankel’s class E from class C recovery. Lumbodorsal pain rate achieved 100%according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by operation.