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
39期
6333-6338
,共6页
王小明%段豪%夏斌%卫建民
王小明%段豪%夏斌%衛建民
왕소명%단호%하빈%위건민
骨科植入物%脊柱植入物%侧卧位椎弓根钉置入%前后联合入路%脊柱外科手术
骨科植入物%脊柱植入物%側臥位椎弓根釘置入%前後聯閤入路%脊柱外科手術
골과식입물%척주식입물%측와위추궁근정치입%전후연합입로%척주외과수술
Bone Nails%Internal Fixators%Spinal Cord Injuries%Spinal Fractures
背景：传统的内固定方式修复脊柱外科损伤容易出现骨折椎体复位效果欠佳的情况，且术后较易出现椎体高度丢失等。<br> 目的：分析前后联合入路行侧卧位椎弓根钉置入在脊柱外科手术中应用的可行性。<br> 方法：选取2013年2月至2014年10月在宝鸡市中医医院行脊柱外科手术的36例患者，根据修复方式分为两组，对照组18例患者单纯予以俯卧位椎弓根钉置入，试验组18例患者采用前后联合入路侧卧位椎弓根钉置入。术后行CT和X射线片检查，对比两组不良置钉率和神经根损伤率；另外比较两组患者的手术时间、住院时间、开始活动时间、术中出血量及美国脊髓损伤协会脊髓损伤水平评分。<br> 结果与结论：两组患者不良置钉率和神经根损伤率比较，差异有显著性意义(P <0.05)，试验组优于对照组。试验组患者的手术时间、开始活动时间、住院时间明显短于对照组(P<0.05)，术中出血量明显低于对照组(P <0.05)，美国脊髓损伤协会脊髓损伤水平评分明显高于对照组(P <0.05)。提示在脊柱外科手术中应用前后联合入路侧卧位椎弓根钉置入内固定，可减少患者术中创伤，缩短住院时间，促进脊髓功能恢复。
揹景：傳統的內固定方式脩複脊柱外科損傷容易齣現骨摺椎體複位效果欠佳的情況，且術後較易齣現椎體高度丟失等。<br> 目的：分析前後聯閤入路行側臥位椎弓根釘置入在脊柱外科手術中應用的可行性。<br> 方法：選取2013年2月至2014年10月在寶鷄市中醫醫院行脊柱外科手術的36例患者，根據脩複方式分為兩組，對照組18例患者單純予以俯臥位椎弓根釘置入，試驗組18例患者採用前後聯閤入路側臥位椎弓根釘置入。術後行CT和X射線片檢查，對比兩組不良置釘率和神經根損傷率；另外比較兩組患者的手術時間、住院時間、開始活動時間、術中齣血量及美國脊髓損傷協會脊髓損傷水平評分。<br> 結果與結論：兩組患者不良置釘率和神經根損傷率比較，差異有顯著性意義(P <0.05)，試驗組優于對照組。試驗組患者的手術時間、開始活動時間、住院時間明顯短于對照組(P<0.05)，術中齣血量明顯低于對照組(P <0.05)，美國脊髓損傷協會脊髓損傷水平評分明顯高于對照組(P <0.05)。提示在脊柱外科手術中應用前後聯閤入路側臥位椎弓根釘置入內固定，可減少患者術中創傷，縮短住院時間，促進脊髓功能恢複。
배경：전통적내고정방식수복척주외과손상용역출현골절추체복위효과흠가적정황，차술후교역출현추체고도주실등。<br> 목적：분석전후연합입로행측와위추궁근정치입재척주외과수술중응용적가행성。<br> 방법：선취2013년2월지2014년10월재보계시중의의원행척주외과수술적36례환자，근거수복방식분위량조，대조조18례환자단순여이부와위추궁근정치입，시험조18례환자채용전후연합입로측와위추궁근정치입。술후행CT화X사선편검사，대비량조불량치정솔화신경근손상솔；령외비교량조환자적수술시간、주원시간、개시활동시간、술중출혈량급미국척수손상협회척수손상수평평분。<br> 결과여결론：량조환자불량치정솔화신경근손상솔비교，차이유현저성의의(P <0.05)，시험조우우대조조。시험조환자적수술시간、개시활동시간、주원시간명현단우대조조(P<0.05)，술중출혈량명현저우대조조(P <0.05)，미국척수손상협회척수손상수평평분명현고우대조조(P <0.05)。제시재척주외과수술중응용전후연합입로측와위추궁근정치입내고정，가감소환자술중창상，축단주원시간，촉진척수공능회복。
BACKGROUND:Traditional internal fixation for thoracolumbar vertebral fractures easily causes poor vertebral reduction, and postoperative vertebral height loss easily appears. <br> OBJECTIVE:To analyze the feasibility of lateral-position pedicle screw placement in spinal surgeryvia combined anterior-posterior approaches. <br> METHODS: A total of 36 cases undergoing spinal surgical operation in the Baoji City Chinese Medicine Hospital from February 2013 to October 2014 were enroled in this study. The patients were divided into two groups according to the method of repair. 18 patients in the control group received prone-position pedicle screw placement, and 18 patients in the experimental group received lateral-position pedicle screw placementvia combined anterior-posterior approaches. Postoperative CT and X-ray examinations compared the adverse rate of screw placement and the rate of nerve root injury between the two groups. Operation time, length of stay, time of beginning movement, intraoperative blood loss and American Spinal Injury Association impairment scale score were compared between the two groups. <br> RESULTS AND CONCLUSION:Significant differences in the adverse rate of screw placement and the rate of nerve root injury were detected between the two groups (P < 0.05), and the adverse rate of screw placement and the rate of nerve root injury were better in the experimental group than in the control group. Operation time, length of stay, and time of beginning movement were significantly better in the experimental group than in the control group (P < 0.05). Intraoperative blood loss was significantly lower in the experimental group than in the control group (P < 0.05). American Spinal Injury Association impairment scale scores were significantly higher in the experimental group than in the control group (P < 0.05). These findings confirm that lateral-position pedicle screw placementvia combined anterior-posterior approaches in spinal surgery can reduce intraoperative trauma, shorten the length of hospital stay, and promote functional recovery of spinal cord.
