摘要
目的评价堆仃段椎弓根螺钉复位同定胸腰椎爆裂性骨折的临床疗效。方法自2003年10月至2008年2月，采用单节段椎11根螺钉吲定治疗A3．1型（37例）、A3．2型（30例）胸腰椎骨折。术后摄X线片束测量骨折椎楔变指数、骨折节段矢状位指数评价影像学效果，并通过腰功能评分评价临床疗效。结果所有患者手术顺利，手术用时平均93min，术中出血量平均157ml。随访65例，平均随访时间为19．8个门（4～27个月），全部骨性融合，除1例出现螺钉松动外，无内固定失败。术前骨折节段平均矢状位指数及骨折椎楔变指数分别为13．06°、42．96％，术后分别为4．47°、21．78％，均较术前明显改善（P〈0．01）。除2例外，最后随访未见明显矫正丢失（P〈0．05）。临床腰功能评分较术前明显改鹭（P〈0．05）。结论经骨折椎单审段复位固定融合术具有创伤小、用时短、出血少、脊椎运动功能单位丢失减少等优点，可用于治疗部分胸腰椎爆裂型骨折。
Objective To evaluate the clinical efficacy of monosegmental pedicle instrumentation in management of thoraeolumbar burst fractures. Methods A total of 67 patients with traumatic thoracolumbar burst fractures （type A3.1 and A3.2） were treated with monosegmental pedicle instrumentation in our department from October 2003 to February 2008. Imageologic effect was observed by measuring sagittal index and wedge index via X-ray and clinical outcomes evaluated by using low back outcome Results All operations were performed successfully, with average operation duration of 93 minutes and average intraoperative blood loss of 157 ml. Of all, 65 patients were followed up for 4-27 months （average 19.8 months） , which showed that all the patients achieved bony fusion, with no implant failure except for one with screw loosening. The sagittal index and wedge index were 13.06° and 42.9% preoperatively and 4.47° and 21.78% postoperatively, with statistical difference （P 〈 0.01 ）. The final follow-up showed no significant correction loss except for two patients （ P 〈 0.05 ）. The low back outcome scores of all patients at follow-up were improved significantly （ P 〈 0.05 ）. Conclusions Monosegmental pedicle instrumentation has advantages of ininimal invasion, short operative duration, less blood loss and less vertebral motion segment loss and hence is an effective and reliable operative technique for thoracolumbar burst fractures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2009年第7期601-604,共4页
Chinese Journal of Trauma
基金
广州市科委科技攻关资助项目（200523-E0401）
关键词
脊柱骨折
胸椎
腰椎
骨折固定术
内
Spinal fractures
Thoracic vertebrae
Lumbar vertebrae
Fracture fixation,internal
