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
13期
2040-2044
,共5页
植入物%脊柱植入物%胸腰椎骨折%后路%短节段%长节段%椎弓根螺钉%内固定%伤椎前缘压缩率%Cobb角变化率
植入物%脊柱植入物%胸腰椎骨摺%後路%短節段%長節段%椎弓根螺釘%內固定%傷椎前緣壓縮率%Cobb角變化率
식입물%척주식입물%흉요추골절%후로%단절단%장절단%추궁근라정%내고정%상추전연압축솔%Cobb각변화솔
Thoracic Vertebrae%Lumbar Vertebrae%Fractures,Bone%Internal Fixators%Bone Nails
背景：后路减压内固定修复胸腰椎骨折效果肯定，又根据处理方法的不同分为短节段与长节段椎弓根螺钉内固定。目前临床上关于两种修复方案的疗效，存在较大争议。目的：对比观察经后路短节段与长节段椎弓根螺钉置入内固定修复胸腰椎骨折患者的伤椎前缘压缩率及Cobb角变化率。方法：纳入胸腰椎骨折患者120例，根据内固定方案分为两组，研究组采用经后路短节段椎弓根螺钉内固定，对照组采用经后路长节段椎弓根螺钉内固定。观察两组患者内固定前、内固定后即刻、内固定后12个月伤椎前缘压缩率以及Cobb角变化率。结果与结论：内固定前两组患者伤椎前缘压缩率、Cobb角变化率差异均无显著性意义(P >0.05)。内固定后即刻及内固定后12个月，可见研究组伤椎前缘压缩率、Cobb角变化率均明显小于对照组，差异均有显著性意义(P <0.05)。此外，研究组患者手术时间、失血量均少于对照组，差异均有显著性意义(P <0.05)。提示经后路短节段椎弓根螺钉置入内固定修复胸腰椎骨折能够有效改善后凸畸形，恢复椎体压缩度，且手术时间短，术中出血量少，优于经后路长节段椎弓根螺钉置入内固定治疗。
揹景：後路減壓內固定脩複胸腰椎骨摺效果肯定，又根據處理方法的不同分為短節段與長節段椎弓根螺釘內固定。目前臨床上關于兩種脩複方案的療效，存在較大爭議。目的：對比觀察經後路短節段與長節段椎弓根螺釘置入內固定脩複胸腰椎骨摺患者的傷椎前緣壓縮率及Cobb角變化率。方法：納入胸腰椎骨摺患者120例，根據內固定方案分為兩組，研究組採用經後路短節段椎弓根螺釘內固定，對照組採用經後路長節段椎弓根螺釘內固定。觀察兩組患者內固定前、內固定後即刻、內固定後12箇月傷椎前緣壓縮率以及Cobb角變化率。結果與結論：內固定前兩組患者傷椎前緣壓縮率、Cobb角變化率差異均無顯著性意義(P >0.05)。內固定後即刻及內固定後12箇月，可見研究組傷椎前緣壓縮率、Cobb角變化率均明顯小于對照組，差異均有顯著性意義(P <0.05)。此外，研究組患者手術時間、失血量均少于對照組，差異均有顯著性意義(P <0.05)。提示經後路短節段椎弓根螺釘置入內固定脩複胸腰椎骨摺能夠有效改善後凸畸形，恢複椎體壓縮度，且手術時間短，術中齣血量少，優于經後路長節段椎弓根螺釘置入內固定治療。
배경：후로감압내고정수복흉요추골절효과긍정，우근거처리방법적불동분위단절단여장절단추궁근라정내고정。목전림상상관우량충수복방안적료효，존재교대쟁의。목적：대비관찰경후로단절단여장절단추궁근라정치입내고정수복흉요추골절환자적상추전연압축솔급Cobb각변화솔。방법：납입흉요추골절환자120례，근거내고정방안분위량조，연구조채용경후로단절단추궁근라정내고정，대조조채용경후로장절단추궁근라정내고정。관찰량조환자내고정전、내고정후즉각、내고정후12개월상추전연압축솔이급Cobb각변화솔。결과여결론：내고정전량조환자상추전연압축솔、Cobb각변화솔차이균무현저성의의(P >0.05)。내고정후즉각급내고정후12개월，가견연구조상추전연압축솔、Cobb각변화솔균명현소우대조조，차이균유현저성의의(P <0.05)。차외，연구조환자수술시간、실혈량균소우대조조，차이균유현저성의의(P <0.05)。제시경후로단절단추궁근라정치입내고정수복흉요추골절능구유효개선후철기형，회복추체압축도，차수술시간단，술중출혈량소，우우경후로장절단추궁근라정치입내고정치료。
BACKGROUND:The effects of posterior decompression fixation in the repair of thoracolumbar fracture are affirmative. The fixation was divided into short-segment and long-segment pedicle screw fixation according to different treatment methods. The therapeutic effects of above two methods are controversial in the clinic at present. OBJECTIVE:To compare and observe the anterior vertebral compression ratio and the changes in Cobb angle after posterior short-segment and long-segment pedicle screw placement fixation in the repair of thoracolumbar fracture. METHODS:120 patients with thoracolumbar fracture were enrol ed in this study, and assigned to two groups according to fixation methods. Study group received posterior short-segment pedicle screw fixation. Control group received posterior long-segment pedicle screw fixation. Anterior vertebral compression rate and Cobb angle were observed before fixation, immediately and 12 months after fixation in both groups. RESULTS AND CONCLUSION:There was no significant difference in anterior vertebral compression rate and Cobb angle between the two groups before fixation (P>0.05). Anterior vertebral compression rate and Cobb angle were significantly smal er in the study group than in the control group immediately and 12 months after fixation (P<0.05). Besides, surgical time and blood loss volume were less in the study group than in the control group (P<0.05). These results indicated that posterior short-segment pedicle screw fixation for treatment of thoracolumbar fracture can effectively improve kyphosis, recover vertebral compression degree, and its surgical time is short and blood loss volume during surgery is little, so it is better than posterior long-segment pedicle screw fixation.
