CAJ | 학술논문

[目的]探讨胸腰椎爆裂性骨折经伤椎椎弓根螺钉内固定(pedicle screw fixation，PSF)治疗的疗效。[方法]选取住院手术治疗的胸腰椎爆裂性骨折52例，均采用经伤椎PSF治疗。比较患者治疗前后疼痛视觉模拟评分（visual analog scale ，VAS）、伤椎椎体前、后缘高度压缩率、椎体后凸畸形矫正度、伤椎骨性椎管占位率变换情况及采用美国脊髓损伤学会(american spinal injury association，ASIA）分级标准评定脊髓神经恢复情况。[结果]52例患者均顺利完成手术，均采用经伤椎PSF治疗。所有病例均获12个月至24个月以上时间随访。患者腰背痛症状于术后得到缓解，伤椎椎体前、后缘高度和局部后凸畸形、伤椎骨性椎管占位率均得到明显改善，脊髓神经功能术后恢复良好，均有1～2级恢复。所有患者未发生内固定松动、折断等现象，伤椎椎体高度无明显丢失，后凸畸形无复发加重。[结论]经伤椎椎弓根内固定不增加固定节段，能很好的恢复伤椎高度，纠正脊柱后凸畸形，达到三平面固定，能有效降低平面四边形效应和悬挂效应，能长时间维持伤椎复位后的位置，无术后伤椎高度再次丢失，后凸畸形复发，甚至断钉、短棒等现象的发生，值得临床上推荐应用。
[목적]탐토흉요추폭렬성골절경상추추궁근라정내고정(pedicle screw fixation，PSF)치료적료효。[방법]선취주원수술치료적흉요추폭렬성골절52례，균채용경상추PSF치료。비교환자치료전후동통시각모의평분（visual analog scale ，VAS）、상추추체전、후연고도압축솔、추체후철기형교정도、상추골성추관점위솔변환정황급채용미국척수손상학회(american spinal injury association，ASIA）분급표준평정척수신경회복정황。[결과]52례환자균순리완성수술，균채용경상추PSF치료。소유병례균획12개월지24개월이상시간수방。환자요배통증상우술후득도완해，상추추체전、후연고도화국부후철기형、상추골성추관점위솔균득도명현개선，척수신경공능술후회복량호，균유1～2급회복。소유환자미발생내고정송동、절단등현상，상추추체고도무명현주실，후철기형무복발가중。[결론]경상추추궁근내고정불증가고정절단，능흔호적회복상추고도，규정척주후철기형，체도삼평면고정，능유효강저평면사변형효응화현괘효응，능장시간유지상추복위후적위치，무술후상추고도재차주실，후철기형복발，심지단정、단봉등현상적발생，치득림상상추천응용。
Objective] To discuss the effect of injured pedicle screw internal fixation(PSF) on thoracolumbar burst fracture. [Method] Choose 52 cases of such disease above treated for operation in hospital, who al take injured PSF for treatment; compare their visual analog scale(VAS), compressibility of front and back edges height of injured vertebra, the correction degree of vertebra kyphosis, the changes injured vertebra bone canalis spinalis perching rate before and after treatment, and take American spinal injury association(ASIA) level standard to evaluate the spinal nerve recovery. [Result] 52 cases al finished the operation smoothly, al took injured vertebra PSF. Al were fol owed up for over 12~24m. After operation, the patients lumbago and back pain was relieved, the front and back edges of injured vertebra, focal kyphosis and canalis spinalis perching rate were relieved a lot, the spinal nerve function recovered wel , in grade 1~2. Al cases had no loose or broken internal fixation, the vertebra height was not missing apparently, the kyphosis didn ’t recur or was severer. [Conclusion] The said fixation doesn ’t add fixed section, can wel recover injured vertebra height, correct spinal kyphosis, reach 3 fixed planes, effectively reduce plane quadrangle efficacy and hanging effect, can long time maintain injured vertebra reposition, without re-missing injured vertebra height, or kyphosis, broken nail, short cane, etc., worth clinical application.