中国实用医刊
中國實用醫刊
중국실용의간
Chinese Journal of Practical Medicine
2015年
21期
56-57,58
,共3页
下腰椎爆裂骨折%椎弓根螺钉%内固定%疗效
下腰椎爆裂骨摺%椎弓根螺釘%內固定%療效
하요추폭렬골절%추궁근라정%내고정%료효
Lower thoracolumbar burst fracture%Pedicle screw%Internal fixation%Curative effect
目的：探讨经后路伤椎椎弓根螺钉内固定手术治疗下腰椎（第3～5腰椎）爆裂骨折的临床效果。方法对23例下腰椎爆裂骨折患者经后路伤椎椎弓根置钉内固定术治疗，评价其术后伤椎复位、脊柱矫形及神经功能恢复情况。结果所有患者手术过程顺利，术后均获植骨融合，术后12～19个月经后路手术取出椎弓根螺钉。随访12～20个月，术后、末次随访时伤椎前高、后高及Cobb角与术前比较差异均有统计学意义（ P＜0．05），术后2周、末次随访时伤椎前高、后高及Cobb角比较差异未见统计学意义（ P＞0．05）。合并神经损伤者末次随访神经功能恢复均≥1级，无椎体塌陷、矫正度明显丢失、内固定物断裂、继发神经损伤等并发症发生。结论经后路伤椎椎弓根置钉内固定术治疗下腰椎爆裂骨折可恢复脊柱前中柱高度，手术创伤较小，术后骨性融合率高，稳定性好，脊柱矫正度丢失不明显，临床疗效确切。
目的：探討經後路傷椎椎弓根螺釘內固定手術治療下腰椎（第3～5腰椎）爆裂骨摺的臨床效果。方法對23例下腰椎爆裂骨摺患者經後路傷椎椎弓根置釘內固定術治療，評價其術後傷椎複位、脊柱矯形及神經功能恢複情況。結果所有患者手術過程順利，術後均穫植骨融閤，術後12～19箇月經後路手術取齣椎弓根螺釘。隨訪12～20箇月，術後、末次隨訪時傷椎前高、後高及Cobb角與術前比較差異均有統計學意義（ P＜0．05），術後2週、末次隨訪時傷椎前高、後高及Cobb角比較差異未見統計學意義（ P＞0．05）。閤併神經損傷者末次隨訪神經功能恢複均≥1級，無椎體塌陷、矯正度明顯丟失、內固定物斷裂、繼髮神經損傷等併髮癥髮生。結論經後路傷椎椎弓根置釘內固定術治療下腰椎爆裂骨摺可恢複脊柱前中柱高度，手術創傷較小，術後骨性融閤率高，穩定性好，脊柱矯正度丟失不明顯，臨床療效確切。
목적：탐토경후로상추추궁근라정내고정수술치료하요추（제3～5요추）폭렬골절적림상효과。방법대23례하요추폭렬골절환자경후로상추추궁근치정내고정술치료，평개기술후상추복위、척주교형급신경공능회복정황。결과소유환자수술과정순리，술후균획식골융합，술후12～19개월경후로수술취출추궁근라정。수방12～20개월，술후、말차수방시상추전고、후고급Cobb각여술전비교차이균유통계학의의（ P＜0．05），술후2주、말차수방시상추전고、후고급Cobb각비교차이미견통계학의의（ P＞0．05）。합병신경손상자말차수방신경공능회복균≥1급，무추체탑함、교정도명현주실、내고정물단렬、계발신경손상등병발증발생。결론경후로상추추궁근치정내고정술치료하요추폭렬골절가회복척주전중주고도，수술창상교소，술후골성융합솔고，은정성호，척주교정도주실불명현，림상료효학절。
Objective To investigate the methods and clinical effects of lower thoracolumbar( L3-5 ) burst fracture treated by posterior pedicle screw internal fixation.Methods The clinical data of 23 patients with lower thoracolumbar burst fracture, who treated by posterior pedicle screw internal fixation from January 2009 to May 2013 were retrospectively analyzed, the wounded vertebra restoration, spine orthopedic and neural functional recovery after the operation were evalua-ted.Results The operations were completed successfully;The bone grafts were fused, 12-19 months later, the pedicle screws were taken out though posterior approach operation.Follow-up visited for 12 to 20 months, after the operation and during the last follow-up visit, the front and back height of the wounded vertebra and the Cobb angle all different from that before the operation, there was a significant difference(P<0.05).The neural functional recovery levels of the patients with associated neurological injury were≥level 1, there were no complications of infection of incisional wound, collapse vertebra, obvious correction lost, internal fixator breakage and secondary nerve injury.Conclusions The trauma of the lumbar burst fracture treated by posterior pedicle screw internal fixationis light, the osseous fusion rate is high after the operation, the ante-rior column height of the spine recover good, the stability is good, it is suitable for clinical to popularize and use.
