中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
4期
548-553
,共6页
植入物%脊柱植入物%腰椎骨折%微创%脊柱内固定物%Sextant系统%目测类比评分%伤椎高度比%后凸Cobb角
植入物%脊柱植入物%腰椎骨摺%微創%脊柱內固定物%Sextant繫統%目測類比評分%傷椎高度比%後凸Cobb角
식입물%척주식입물%요추골절%미창%척주내고정물%Sextant계통%목측류비평분%상추고도비%후철Cobb각
Lumbar Vertebrae%Fractures,Bone%Internal Fixators%Surgical Procedures,Minimaly Invasive%Pain Measurement
背景：腰椎后路椎弓根螺钉内固定已成为腰椎压缩性骨折常见的治疗方式之一，传统手术切开行椎弓根螺钉内固定通常产生较多局部肌肉组织的损伤，在微创下进行腰椎内固定是脊柱微创外科的一大进展。
<br> 目的：探讨经皮微创Sextant内固定系统修复腰椎骨折的临床效果，对比观察内固定前后患者目测类比评分、伤椎前后缘高度比以及脊柱后凸Cobb角变化。
<br> 方法：选择58例腰椎压缩骨折患者资料进行回顾性分析。所有病例均由同一高年资骨科副主任医师(第二作者)于2008年1月至2013年12月在成都市第一人民医院骨科完成。均行经后路腰椎Sextant系统内固定。主要观察术中失血量，内固定前后目测类比评分、伤椎前后缘高度比以及脊柱后凸Cobb角变化。
<br> 结果与结论：术中平均出血量40 mL，内固定后平均引流量80 mL，内固定后患者腰背部疼痛明显缓解(P <0.01)，平均卧床2周即可下地行早期功能康复锻炼。内固定后伤椎前后缘高度比及后凸Cobb角均较内固定前有明显改善(P <0.05)，未出现螺钉松动、断裂。说明经后路腰椎Sextant系统内固定修复腰椎压缩性骨折，能够较好的恢复椎体前缘高度、矫正脊柱后凸，并且失血量少，内固定后疼痛症状轻，便于患者术后早期功能锻炼。
揹景：腰椎後路椎弓根螺釘內固定已成為腰椎壓縮性骨摺常見的治療方式之一，傳統手術切開行椎弓根螺釘內固定通常產生較多跼部肌肉組織的損傷，在微創下進行腰椎內固定是脊柱微創外科的一大進展。
<br> 目的：探討經皮微創Sextant內固定繫統脩複腰椎骨摺的臨床效果，對比觀察內固定前後患者目測類比評分、傷椎前後緣高度比以及脊柱後凸Cobb角變化。
<br> 方法：選擇58例腰椎壓縮骨摺患者資料進行迴顧性分析。所有病例均由同一高年資骨科副主任醫師(第二作者)于2008年1月至2013年12月在成都市第一人民醫院骨科完成。均行經後路腰椎Sextant繫統內固定。主要觀察術中失血量，內固定前後目測類比評分、傷椎前後緣高度比以及脊柱後凸Cobb角變化。
<br> 結果與結論：術中平均齣血量40 mL，內固定後平均引流量80 mL，內固定後患者腰揹部疼痛明顯緩解(P <0.01)，平均臥床2週即可下地行早期功能康複鍛煉。內固定後傷椎前後緣高度比及後凸Cobb角均較內固定前有明顯改善(P <0.05)，未齣現螺釘鬆動、斷裂。說明經後路腰椎Sextant繫統內固定脩複腰椎壓縮性骨摺，能夠較好的恢複椎體前緣高度、矯正脊柱後凸，併且失血量少，內固定後疼痛癥狀輕，便于患者術後早期功能鍛煉。
배경：요추후로추궁근라정내고정이성위요추압축성골절상견적치료방식지일，전통수술절개행추궁근라정내고정통상산생교다국부기육조직적손상，재미창하진행요추내고정시척주미창외과적일대진전。
<br> 목적：탐토경피미창Sextant내고정계통수복요추골절적림상효과，대비관찰내고정전후환자목측류비평분、상추전후연고도비이급척주후철Cobb각변화。
<br> 방법：선택58례요추압축골절환자자료진행회고성분석。소유병례균유동일고년자골과부주임의사(제이작자)우2008년1월지2013년12월재성도시제일인민의원골과완성。균행경후로요추Sextant계통내고정。주요관찰술중실혈량，내고정전후목측류비평분、상추전후연고도비이급척주후철Cobb각변화。
<br> 결과여결론：술중평균출혈량40 mL，내고정후평균인류량80 mL，내고정후환자요배부동통명현완해(P <0.01)，평균와상2주즉가하지행조기공능강복단련。내고정후상추전후연고도비급후철Cobb각균교내고정전유명현개선(P <0.05)，미출현라정송동、단렬。설명경후로요추Sextant계통내고정수복요추압축성골절，능구교호적회복추체전연고도、교정척주후철，병차실혈량소，내고정후동통증상경，편우환자술후조기공능단련。
BACKGROUND:Posterior lumbar pedicle screw fixation has been a common method to treat vertebral compression fractures. Traditional surgical incision of pedicle screw fixation commonly produces many local muscle tissue damages. Lumbar fixation by minimaly invasive method is a big progress in minimaly invasive spine surgery.
<br> OBJECTIVE:To investigate the therapeutic results of Sextant system with percutaneous pedicle screw fixation for the treatment of lumbar fracture, and to compare the changes in visual analog scale, the ratio of anterior to posterior border height of the injured vertebra, and kyphosis Cobb angle before and after fixation.
<br> METHODS:Data of 58 cases of vertebral compression fractures were retrospectively analyzed. Al cases were treated by the senior associate chief physician (second author) at the Department of Orthopedics, the First People’s Hospital of Chengdu from January 2008 to December 2013. They received Sextant system with percutaneous pedicle screw fixation. Intraoperative blood loss, the changes in visual analog scale, the ratio of anterior to posterior border height of the injured vertebra, and kyphosis Cobb angle before and after fixation were observed.
<br> RESULTS AND CONCLUSION: The average blood loss during the surgery was 40 mL, with an average post-surgery drainage of 80 mL. Postoperative lumbar back pain was significantly reduced (P < 0.01). After 2 weeks of lying in bed, they could do early functional rehabilitation exercises. The ratio of anterior to posterior border height of the injured vertebra, and kyphosis Cobb angle were significantly improved after fixation (P < 0.05). There was no screw loosening or breakage. These data suggested that the Sextant system with percutaneous pedicle screw fixation for vertebral compression fractures can better restore the anterior border height and correct kyphosis. Moreover, blood loss is less. Pain became mild after fixation, which is convenient to early functional exercises after the surgery.
