摘要
背景:传统的内固定方式修复胸腰椎骨折容易出现骨折椎体复位效果欠佳的情况,且内固定后较易出现椎体高度丢失等。而采用后路短节段椎弓根螺钉内固定的方法修复胸腰椎骨折则可以有效矫正患者的后凸畸形,并维持矫正效果。目的:探讨经后路短节段椎弓根钉系统内固定及椎板植骨修复胸腰椎骨折的临床效果。方法:对上海交通大学附属上海第一人民医院骨科2009年3月至2013年11月收治的41例经胸腰椎后路切开复位、短节段椎弓根钉内固定及椎板植骨修复胸腰椎骨折患者的临床资料进行回顾性分析。对患者行X射线及CT检查,观察内固定情况,其他观察指标包括腰椎功能的日本骨科协会评分、目测类比评分、脊柱侧弯情况、伤椎前后缘高度比及脊髓神经功能改善情况。结果与结论:内固定后随访5个月-4年1个月,所有患者术后1年左右骨折愈合后取出内固定。经随访发现内固定物松动1例、断裂2例(术中发现骨折段未有效融合),未出现继发性脊柱后凸畸形加重。内固定后5个月,患者的伤椎高度显著恢复,脊髓功能得到明显改善,表明经后路短节段椎弓根钉系统内固定及椎板植骨治疗胸腰椎骨折可以获得良好的修复效果。
BACKGROUND：Traditional internal fixation for treating the thoracic and lumbar vertebral fracture is prone to induce poor reduction and loss of vertebral height. While the use of posterior short-segment pedicle screw internal fixation can effectively correct the kyphosis and maintain the correcting effect in the treatment of thoracolumbar fracture.
OBJECTIVE：To explore the clinical effect of posterior short-segment pedicle screw fixation and posterolateral bone graft fusion in treatment of thoracolumbar fracture.
METHODS：A retrospective analysis was performed on the clinical data of 41 patients who underwent thoracic and lumbar posterior open reduction, internal fixation of short-segment pedicle screw system and posterolateral bone graft fusion for the treatment of thoracolumbar fractures in the First People’s Hospital Affiliated to Shanghai Jiaotong University from March 2009 to November 2013. Patients were detected by X-ray and CT examination, to observe internal fixation effect. In addition, lumbar function improvement （Japanese Orthopaedic Association Scores, Visual Analog Score, scoliosis, vertebral edge height ratio, and spinal nerve function） was also assessed.
RESULTS AND CONCLUSION：Patients were fol owed up for 5 months to 4 years and 1 month after internal fixation. Al patients achieved fracture healing and the internal fixators were removed 1 year after surgery. Fol ow-up results showed that, 1 case appeared the loosening and 2 cases appeared the fracture （fracture ends were not effectively fused during operation）, no cases appeared secondary spinal kyphotic deformity aggravation.＆nbsp;Height of injured vertebra was significantly recovered and the spinal nerve function was obviously improved at 5 months after surgery. Posterior short-segment pedicle screw fixation and posterolateral bone graft fusion can obtain good clinical curative effect in treatment of thoracolumbar fracture.
出处
《中国组织工程研究》
CAS
北大核心
2015年第9期1365-1370,共6页
Chinese Journal of Tissue Engineering Research
基金
上海市科技委员会研究项目:GJZ Co-Cr-Mo合金生物型脊柱关节临床研究
课题编号:12441900702~~
