临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
10期
826-828,829
,共4页
胸腰椎%骨折%脱位%后路复位%固定椎体
胸腰椎%骨摺%脫位%後路複位%固定椎體
흉요추%골절%탈위%후로복위%고정추체
Thoracolumbar%Fracture%Dislocation%Posterior reduction%Fixation
目的：通过临床观察探讨后路复位固定椎体间植骨融合治疗胸腰椎骨折脱位的临床疗效及对神经功能的影响。方法选取2009年6月至2013年12月以胸腰椎骨折脱位为诊断而入院患者44例，全部采取自后路复位固定椎体间植骨融合术治疗，统计患者的手术时间、术中出血量、Cobb角度、以及伤椎椎体前缘高度，术后随访了解患者的骨折复位情况、植骨融合愈合情况以及神经功能情况。结果44例患者均获随访，随访时间为8~34个月，平均12.5个月。手术时间为3.0~5.7 h，平均3.7 h；术中失血320~1250 ml，平均440 ml；Cobb角度术前（31.6±3.6）°，术后为（13.9±2.4）°；伤椎椎体前缘高度术前相邻正常椎体（41.1±11.7）％，术后椎椎体前缘高度术前相邻正常椎体（87.7±2.3）％。神经功能恢复情况：术前Frankel评价A级患者8例，其中4例恢复至B级，4例恢复至C级；术前Frankel B级患者12例，其中7例恢复到C级，4例恢复至D级，有1例恢复至E级；术前Frankel C级患者18例，9例恢复到D级，另9例恢复至E级；6例 Frankel D级患者恢复正常。DR示植骨均获得融合，无松动、断裂，恢复较好。结论后路复位固定椎体间植骨融合治疗胸腰椎骨折脱位的临床疗效可靠，可有效恢复伤椎高度，术后神经功能恢复也较好。
目的：通過臨床觀察探討後路複位固定椎體間植骨融閤治療胸腰椎骨摺脫位的臨床療效及對神經功能的影響。方法選取2009年6月至2013年12月以胸腰椎骨摺脫位為診斷而入院患者44例，全部採取自後路複位固定椎體間植骨融閤術治療，統計患者的手術時間、術中齣血量、Cobb角度、以及傷椎椎體前緣高度，術後隨訪瞭解患者的骨摺複位情況、植骨融閤愈閤情況以及神經功能情況。結果44例患者均穫隨訪，隨訪時間為8~34箇月，平均12.5箇月。手術時間為3.0~5.7 h，平均3.7 h；術中失血320~1250 ml，平均440 ml；Cobb角度術前（31.6±3.6）°，術後為（13.9±2.4）°；傷椎椎體前緣高度術前相鄰正常椎體（41.1±11.7）％，術後椎椎體前緣高度術前相鄰正常椎體（87.7±2.3）％。神經功能恢複情況：術前Frankel評價A級患者8例，其中4例恢複至B級，4例恢複至C級；術前Frankel B級患者12例，其中7例恢複到C級，4例恢複至D級，有1例恢複至E級；術前Frankel C級患者18例，9例恢複到D級，另9例恢複至E級；6例 Frankel D級患者恢複正常。DR示植骨均穫得融閤，無鬆動、斷裂，恢複較好。結論後路複位固定椎體間植骨融閤治療胸腰椎骨摺脫位的臨床療效可靠，可有效恢複傷椎高度，術後神經功能恢複也較好。
목적：통과림상관찰탐토후로복위고정추체간식골융합치료흉요추골절탈위적림상료효급대신경공능적영향。방법선취2009년6월지2013년12월이흉요추골절탈위위진단이입원환자44례，전부채취자후로복위고정추체간식골융합술치료，통계환자적수술시간、술중출혈량、Cobb각도、이급상추추체전연고도，술후수방료해환자적골절복위정황、식골융합유합정황이급신경공능정황。결과44례환자균획수방，수방시간위8~34개월，평균12.5개월。수술시간위3.0~5.7 h，평균3.7 h；술중실혈320~1250 ml，평균440 ml；Cobb각도술전（31.6±3.6）°，술후위（13.9±2.4）°；상추추체전연고도술전상린정상추체（41.1±11.7）％，술후추추체전연고도술전상린정상추체（87.7±2.3）％。신경공능회복정황：술전Frankel평개A급환자8례，기중4례회복지B급，4례회복지C급；술전Frankel B급환자12례，기중7례회복도C급，4례회복지D급，유1례회복지E급；술전Frankel C급환자18례，9례회복도D급，령9례회복지E급；6례 Frankel D급환자회복정상。DR시식골균획득융합，무송동、단렬，회복교호。결론후로복위고정추체간식골융합치료흉요추골절탈위적림상료효가고，가유효회복상추고도，술후신경공능회복야교호。
Objective To investigate the clinical efficacy of posterior reduction fixation and interbody fusion for the treatment of thoraco-lumbar fracture dislocation and its impact on neurological function. Methods From June 2009 to December 2013,44 cases of thoracolumbar frac-ture dislocation hospitalized in the hospital were treated with posterior reduction fixation and interbody fusion. Operative time,blood loss,Cobb an-gle,and the leading edge of vertebral body height were recorded. Fusion healing and neurological conditions were observed during postoperative follow-up. Results The patients were followed-up for 8 to 34 months(mean 12. 5 months). Operative time was 3. 0 to 5. 7 hours(mean 3. 7hours). Intraoperativebloodlosswas320~1250ml(mean440ml). Cobbanglewas31.6°±3.6°beforesurgeryand13.9°±2.4°after surgery. The leading edge of the injured vertebral body was 41. 1 ± 11. 7% of that of adjacent normal vertebral body before surgery,and it was 87. 7 ± 2. 3% after surgery. Of 8 patients evaluated preoperatively as Frankel grade A,4 were improved to grade B,4 to grade C;of 12 preoperative Frankel grade B patients,7 were improved to grade C,4 to grade D,and one to grade E postoperation;of 18 preoperative Frankel grade C pa-tients,9 were improved to grade D,9 to grade E;and all 6 preoperative Frankel grade D patients returned to normal. DR showed bone fusion, without loosening and fracture. Conclusion Posterior reduction fixation and lumbar interbody fusion is effective for the treatment of thoracolumbar fracture dislocation and neurological recovery of the patients is satisfactory.
