摘要
目的比较使用Sextant内固定系统治疗胸腰段椎体骨折附加病椎椎弓根钉固定与跨病椎固定的临床疗效。方法选择武汉大学人民医院2013年1月至2016年1月收治的70例胸腰段椎体骨折患者,其中男性38例,女性32例;年龄37~53岁,平均年龄45.3岁。根据入院顺序随机分为附加病椎固定组(A组,35例)和跨病椎固定组(B组,35例)。采用Sextant内固定系统,A组将病椎及其上下相邻椎体共同固定;B组仅固定病椎上下相邻椎体,不对病椎进行处理。分别统计患者的手术时间、术中出血量、术后并发症发生率及术前、术后病椎前后缘高度比值、腰椎后凸畸形程度、视觉模拟量表(VAS)评分情况。结果所有患者均获得至少1年随访时间。两组患者在手术时间、术中出血量、术后伤口疼痛方面差异无统计学意义(P>0.05)。术后病椎椎体前缘高度比(92.1%±6.9%vs 82.9%±5.7%)、椎体前后缘高度比(84.1%±3.9%vs 70.9%±5.7%)、腰椎后凸畸形改善方面,A组明显优于B组,差异具有统计学意义(P<0.05)。术后并发症A组疼痛2例,并发症发生率5.71%;B组断钉4例,疼痛3例,并发症发生率20.00%;两组比较,差异有统计学意义(P<0.05)。结论附加病椎椎弓根螺钉内固定力学稳定性更好,并且在恢复椎体高度、改善腰椎后凸畸形、维持椎体高度上明显优于跨伤椎固定。因此,对于单节段、单纯胸腰段椎体压缩性骨折患者,使用经皮Sextant椎弓根螺钉内固定系统附加病椎椎弓根螺钉固定是更为理想的治疗方法。
Objective To compare the clinical efficacy of thoracolumbar vertebral fracture additional fixation injury vertebral and crossing fixation injury vertebral with Sextant internal fixation system. Methods From January 2013 to January 2016, a total of 70 thoracolumbar fracture patients were enrolled, which included 38 males and 32 females, aged 37-53 years old with mean age of 45.3 years old. All of them were randomly divided into additional fixation injury vertebral group（group A, n = 35）and cross fixation injury vertebral group（group B, n = 35） in admission order. With Sextant internal fixation system, vertebrae and its upper and lower vertebral were together fixed in group A, but the upper and lower vertebral were only fixed in group B. The operative time, intraoperative blood loss, postoperative complication incidences, ratio of anteroposterior vertebral height before and after operation, degree of lumbar kyphosis, and visual analog scale（VAS） score were statistically analyzed.Results All patients were followed-up for at least 1 year, there was no significant difference in operative time, intraoperative blood loss and postoperative wound pain between 2 groups（P〈0.05）. The anteroior vertebral height ratio after operation（92.1 % ±6.9 % vs 82.9 % ± 5.7 %）, ratio of anteroposterior vertebral height（84.1 % ± 3.9 % vs 70.9 % ± 5.7 %）, and improvement of lumbar kyphosis in group A was significant better than that in group B, the difference was statistically significant（ P〈0.05）.The postoperative complication of pain occurred 2 cases in group A, the complications incidence was 5.71 %; The postopera-tive complication of group B in 4 cases of broken nails and 3 cases of pain, the complication incidence was 20.00 %, the dif-ference was statistically significant between 2 groups（P〈0.05）. Conclusion It is demonstrated that the internal fixation of additional injury vertebral fixation showed better mechanical stability, which is better than that of cross injury vertebral fixation in restoring, improving and maintaining height of vertebral. Therefore, additional fixation injury vertebral with percutaneous Sex-tant internal fixation system is an ideal treatment method.
出处
《生物医学工程与临床》
CAS
2017年第6期633-637,共5页
Biomedical Engineering and Clinical Medicine
关键词
胸腰椎骨折
病椎
椎体高度
高度比
疼痛
疗效
thoracolumbar fractures
vertebral fractures
vertebral height
height ratio
pain
curative effect
