中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
6期
492-496
,共5页
王辉%马雷%张迪%杨大龙%孙亚澎%丁文元
王輝%馬雷%張迪%楊大龍%孫亞澎%丁文元
왕휘%마뢰%장적%양대룡%손아팽%정문원
胸椎%腰椎%骨折%截骨术
胸椎%腰椎%骨摺%截骨術
흉추%요추%골절%절골술
Thoracic vertebrae%Lumber vertebrae%Fractures,bone%Osteotomy
目的 探讨后方单侧截骨入路椎体大部分切除固定矫形术(PUVCR)治疗陈旧性胸腰段椎体压缩骨折伴后凸畸形的疗效. 方法 自2009年2月至2013年1月共49例陈旧性胸腰段椎体压缩骨折伴后凸畸形患者纳入本项研究,根据治疗方式不同分为PUVCR组(接受PUVCR,23例)和后路椎体切除术(PVCR)组(接受PVCR,26例).两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性.记录并比较两组患者手术时间、术中出血量、术后引流量、后凸cobb角矫正情况、神经功能改善情况及疼痛评分的缓解程度. 结果 与PVCR组比较,PUVCR组的手术时间更短、术中出血量更少、术后引流量更少,差异均有统计学意义(P<0.05).术后2周后凸cobb角的矫正度和术后1年后凸cobb角矫正丢失度两组间比较,差异均无统计学意义(P>0.05).术后1年神经功能改善情况和疼痛评分缓解程度两组间比较,差异均无统计学意义(P>0.05). 结论 对于陈旧性胸腰段椎体压缩骨折伴后凸畸形,PUVCR可取得与传统截骨方式相同程度的后凸畸形矫正、神经功能恢复及疼痛改善,但手术时间更短、出血更少、神经损伤发生率更低.
目的 探討後方單側截骨入路椎體大部分切除固定矯形術(PUVCR)治療陳舊性胸腰段椎體壓縮骨摺伴後凸畸形的療效. 方法 自2009年2月至2013年1月共49例陳舊性胸腰段椎體壓縮骨摺伴後凸畸形患者納入本項研究,根據治療方式不同分為PUVCR組(接受PUVCR,23例)和後路椎體切除術(PVCR)組(接受PVCR,26例).兩組患者術前一般資料比較差異均無統計學意義(P>0.05),具有可比性.記錄併比較兩組患者手術時間、術中齣血量、術後引流量、後凸cobb角矯正情況、神經功能改善情況及疼痛評分的緩解程度. 結果 與PVCR組比較,PUVCR組的手術時間更短、術中齣血量更少、術後引流量更少,差異均有統計學意義(P<0.05).術後2週後凸cobb角的矯正度和術後1年後凸cobb角矯正丟失度兩組間比較,差異均無統計學意義(P>0.05).術後1年神經功能改善情況和疼痛評分緩解程度兩組間比較,差異均無統計學意義(P>0.05). 結論 對于陳舊性胸腰段椎體壓縮骨摺伴後凸畸形,PUVCR可取得與傳統截骨方式相同程度的後凸畸形矯正、神經功能恢複及疼痛改善,但手術時間更短、齣血更少、神經損傷髮生率更低.
목적 탐토후방단측절골입로추체대부분절제고정교형술(PUVCR)치료진구성흉요단추체압축골절반후철기형적료효. 방법 자2009년2월지2013년1월공49례진구성흉요단추체압축골절반후철기형환자납입본항연구,근거치료방식불동분위PUVCR조(접수PUVCR,23례)화후로추체절제술(PVCR)조(접수PVCR,26례).량조환자술전일반자료비교차이균무통계학의의(P>0.05),구유가비성.기록병비교량조환자수술시간、술중출혈량、술후인류량、후철cobb각교정정황、신경공능개선정황급동통평분적완해정도. 결과 여PVCR조비교,PUVCR조적수술시간경단、술중출혈량경소、술후인류량경소,차이균유통계학의의(P<0.05).술후2주후철cobb각적교정도화술후1년후철cobb각교정주실도량조간비교,차이균무통계학의의(P>0.05).술후1년신경공능개선정황화동통평분완해정도량조간비교,차이균무통계학의의(P>0.05). 결론 대우진구성흉요단추체압축골절반후철기형,PUVCR가취득여전통절골방식상동정도적후철기형교정、신경공능회복급동통개선,단수술시간경단、출혈경소、신경손상발생솔경저.
Objective To describe a successful method by which vertebral column resection is performed through a unilateral posterior approach for old thoracolumbar compressive fracture accompanied with kyphotic deformity.Methods From February 2009 to January 2013,49 patients with old thoracolumbar compressive fracture accompanied with kyphotic deformity were treated at our department.Twenty-three of them were treated by posterior unilateral vertebral column resection (PUVCR),and 26 by posterior vertebral column resection (PVCR).The 2 groups were compatible in general clinical data (P > 0.05).Their clinical records were reviewed and compared in terms of operation time,intraoperative blood loss,postoperative drainage,correction of kyphotic deformity,neural functional improvement by Oswestry disability index (ODI),and pain by visual analogue scale (VAS).Results The operation time,intraoperative blood loss and postoperative drainage in the PUVCR group were significantly less than in the PVCR group (P < 0.05).There were no significant differences between the 2 groups in terms of correction of kyphotic angle (P =0.523) postoperatively or loss of correction (P =0.146) at one-year follow-up (P > 0.05).No significant differences were observed between the 2 groups either in terms of improved ODI or decreased VAS at one-year follow-up (P > 0.05).Conclusions In treatment of old thoracolumbar compressive fracture accompanied with kyphotic deformity,PUVCR can achieve satisfactory correction of sagittal deformity,neural functional improvement and pain relief as well as conventional osteotomy,but it has advantages of shorter operation time,reduced blood loss and decreased incidence of nerve root impingement.