医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2014年
6期
1044-1046
,共3页
周建华%张昊%菅新民%胡亚威%张弦
週建華%張昊%菅新民%鬍亞威%張絃
주건화%장호%관신민%호아위%장현
脊柱骨折/外科学%胸椎%腰椎
脊柱骨摺/外科學%胸椎%腰椎
척주골절/외과학%흉추%요추
Spinal Fractures/SU%Thoracic Vertebrae%Lumbar Vertebrae
【目的】探讨可扩张通道管(QUADRANT)系统下经伤椎置钉单节段治疗胸腰椎骨折的疗效。【方法】收集胸腰椎骨折患者50例,采用C臂 X线机透视定位,在后路 QUADRANT系统下伤椎置钉单节段内固定植骨融合,对比分析术前、术后神经功能 ASIA分级、伤椎椎体的高度及 Cobb角。【结果】所有患者均得到随访。手术平均切口长度3.5 cm,平均手术时间53 min,术中平均出血量125 mL,1例切口皮缘有坏死,经过对症治疗后愈合。术后所有患者均骨性融合,2例ASIA C级神经功能均恢复至正常,X线检查术后伤椎高度恢复到95.9%,随访椎体高度丢失0.4 mm,丢失率为1.4%;Cobb角由术前19.5°(12.6°~26.4°)恢复到术后4.1°(1.5°~6.3°),无内固定物松动、移位、断裂。【结论】在后路QUADRANT系统下伤椎置钉单节段治疗胸腰段骨折,是一种创伤小、手术时间短、出血量少、疗效好、操作安全的手术方法。
【目的】探討可擴張通道管(QUADRANT)繫統下經傷椎置釘單節段治療胸腰椎骨摺的療效。【方法】收集胸腰椎骨摺患者50例,採用C臂 X線機透視定位,在後路 QUADRANT繫統下傷椎置釘單節段內固定植骨融閤,對比分析術前、術後神經功能 ASIA分級、傷椎椎體的高度及 Cobb角。【結果】所有患者均得到隨訪。手術平均切口長度3.5 cm,平均手術時間53 min,術中平均齣血量125 mL,1例切口皮緣有壞死,經過對癥治療後愈閤。術後所有患者均骨性融閤,2例ASIA C級神經功能均恢複至正常,X線檢查術後傷椎高度恢複到95.9%,隨訪椎體高度丟失0.4 mm,丟失率為1.4%;Cobb角由術前19.5°(12.6°~26.4°)恢複到術後4.1°(1.5°~6.3°),無內固定物鬆動、移位、斷裂。【結論】在後路QUADRANT繫統下傷椎置釘單節段治療胸腰段骨摺,是一種創傷小、手術時間短、齣血量少、療效好、操作安全的手術方法。
【목적】탐토가확장통도관(QUADRANT)계통하경상추치정단절단치료흉요추골절적료효。【방법】수집흉요추골절환자50례,채용C비 X선궤투시정위,재후로 QUADRANT계통하상추치정단절단내고정식골융합,대비분석술전、술후신경공능 ASIA분급、상추추체적고도급 Cobb각。【결과】소유환자균득도수방。수술평균절구장도3.5 cm,평균수술시간53 min,술중평균출혈량125 mL,1례절구피연유배사,경과대증치료후유합。술후소유환자균골성융합,2례ASIA C급신경공능균회복지정상,X선검사술후상추고도회복도95.9%,수방추체고도주실0.4 mm,주실솔위1.4%;Cobb각유술전19.5°(12.6°~26.4°)회복도술후4.1°(1.5°~6.3°),무내고정물송동、이위、단렬。【결론】재후로QUADRANT계통하상추치정단절단치료흉요단골절,시일충창상소、수술시간단、출혈량소、료효호、조작안전적수술방법。
[Obj ective]To explore the efficacy of pedicle screw placement in single segment of the inj ured verte-bra by posterior Quadrant system for the treatment of thoracolumbar fracture.[Methods]Totally 50 patients with tho-racolumbar fracture were collected.After localization by C-arm fluoroscopy,all patients underwent pedicellscrew placement in single segment,internal fixation and bone graft infusion by posterior QUADRANT system.ASIA clas-sification of nerve function,vertebra height and Cobb angle before and after operation were analyzed and compared.[Results]All patients were followed up.The mean incision length was 3 .5 cm.The average operation time was 53min.The average bleeding volume was 125mL.One patient with incision skin edge necrosis was cured by symp-tomatic treatment.All patients after operation had bony fusion.ASIA grade C neural function of 2 patients recovered to normal.Postoperative X-ray examination showed that the inj ured vertebral height recovered to 9 5 .9%.During the follow up,the vertebral height only lost 0.4mm,and the lost rate was 1.4%.The Cobb angle recovered from preop-erative e 19.5°(12.6°~26.4°)to postoperative 4.1°(1.5°~6.3°).No internal fixation loosening,shift and breakage fracture were found.[Conclusion]Pedicle screw placement in single segment of the inj ured vertebra by posterior Quadrant system for the treatment of thoracolumbar fracture is a surgical method with minimal trauma,short opera-tion time,less blood loss,good efficacy and safe operation.