脊柱外科杂志
脊柱外科雜誌
척주외과잡지
JOURNAL OF SPINE SURGERY
2015年
1期
16-19
,共4页
黄剑侯%刘竞龙%孙俊凯%贾连顺
黃劍侯%劉競龍%孫俊凱%賈連順
황검후%류경룡%손준개%가련순
胸椎%腰椎%脊柱骨折%脊柱后凸%内固定器%截骨术%矫形外科手术
胸椎%腰椎%脊柱骨摺%脊柱後凸%內固定器%截骨術%矯形外科手術
흉추%요추%척주골절%척주후철%내고정기%절골술%교형외과수술
Thoracic vertebrae%Lumbar vertebrae%Spinal fractures%Kyphosis%Internal fixators%Osteotomy%Orthopedic procedures
目的：评价改良经椎弓根截骨矫形术（ transpedicular subtraction osteotomy， PSO）治疗陈旧性胸腰椎骨折伴后凸畸形的临床效果和安全性。方法回顾分析本院2008年1月～2012年10月采用改良PSO治疗的16例陈旧性胸腰椎骨折伴后凸畸形患者临床资料，对所有患者的矫正情况、置入钛网的高度进行随访，采用疼痛视觉模拟量表（ visual analogue scale，VAS）评分、Oswestry功能障碍指数（ Oswestry disability index，ODI）对腰椎功能进行评估。结果随访12～24个月，平均18．9个月，手术时间190～305 min，平均220 min，术中出血量1400～2450 mL，平均1740 mL。所有患者术后均获得功能及自我形象的改善，腰痛VAS评分下降了（6．3±1．4）分，ODI下降了（52．12±7．43）％，获得34．6°±3．2°的后凸角的矫正，末次随访时矫正度数丢失1．6°。融合率为87．5％。1例患者出现大腿前侧皮肤麻木，术后3个月随访痊愈。结论改良PSO治疗陈旧性胸腰椎骨折伴后凸畸形安全、有效。
目的：評價改良經椎弓根截骨矯形術（ transpedicular subtraction osteotomy， PSO）治療陳舊性胸腰椎骨摺伴後凸畸形的臨床效果和安全性。方法迴顧分析本院2008年1月～2012年10月採用改良PSO治療的16例陳舊性胸腰椎骨摺伴後凸畸形患者臨床資料，對所有患者的矯正情況、置入鈦網的高度進行隨訪，採用疼痛視覺模擬量錶（ visual analogue scale，VAS）評分、Oswestry功能障礙指數（ Oswestry disability index，ODI）對腰椎功能進行評估。結果隨訪12～24箇月，平均18．9箇月，手術時間190～305 min，平均220 min，術中齣血量1400～2450 mL，平均1740 mL。所有患者術後均穫得功能及自我形象的改善，腰痛VAS評分下降瞭（6．3±1．4）分，ODI下降瞭（52．12±7．43）％，穫得34．6°±3．2°的後凸角的矯正，末次隨訪時矯正度數丟失1．6°。融閤率為87．5％。1例患者齣現大腿前側皮膚痳木，術後3箇月隨訪痊愈。結論改良PSO治療陳舊性胸腰椎骨摺伴後凸畸形安全、有效。
목적：평개개량경추궁근절골교형술（ transpedicular subtraction osteotomy， PSO）치료진구성흉요추골절반후철기형적림상효과화안전성。방법회고분석본원2008년1월～2012년10월채용개량PSO치료적16례진구성흉요추골절반후철기형환자림상자료，대소유환자적교정정황、치입태망적고도진행수방，채용동통시각모의량표（ visual analogue scale，VAS）평분、Oswestry공능장애지수（ Oswestry disability index，ODI）대요추공능진행평고。결과수방12～24개월，평균18．9개월，수술시간190～305 min，평균220 min，술중출혈량1400～2450 mL，평균1740 mL。소유환자술후균획득공능급자아형상적개선，요통VAS평분하강료（6．3±1．4）분，ODI하강료（52．12±7．43）％，획득34．6°±3．2°적후철각적교정，말차수방시교정도수주실1．6°。융합솔위87．5％。1례환자출현대퇴전측피부마목，술후3개월수방전유。결론개량PSO치료진구성흉요추골절반후철기형안전、유효。
Objective To evaluate the efficacy and safety of modified pedicle subtraction osteotomy for thoracolumbar old fracture with kyphosis.Methods From January 2008 to October 2012, 16 patients of thoracolumbar kyphosis underwent modified pedicle subtraction osteotomy were reviewed.Preoperative and postoperative kyphotic Cobb's angle, visual analogue scale( VAS) score of back pain, Oswestry disability index( ODI) , as well as titanium mesh height inserted, the incidence of complication were accessed.Results Mean follow-up duration was 18.9 months.Average operative time was 220 min(190-305 min) and average bleeding was 1 740 mL(1 400-2 450 mL) .All the patients were significantly improved in function and self-image, and obtained kyphosis correction with 34.6 °±3.2 °.VAS score of low back pain was decreased by 6.3 ±1.4, ODI was dropped (52.12 ±7.43)%, the final follow-up degree of correction lost 1.6°.Fusion rate was 87.5%.One patient suffered anterior thigh numbness and get recovery after 3 months of follow-up.Conclusion Modified pedicle subtrac-tion osteotomy is a safe and effective technique for the treatment of old fracture with kyphosis.
