摘要
目的探讨CT引导下椎板间开窗减压在单节段A3型腰椎爆裂骨折手术中的应用效果。方法对2017年1月至2019年6月于郑州大学第一附属医院骨科行跨伤椎短节段内固定的56例单节段A3型腰椎爆裂骨折患者进行回顾性研究。按照是否CT引导分为CT引导组(CT引导)和非CT引导组(无CT引导)。评价两组的围手术期指标、临床疗效、生活质量、影像学参数、并发症发生率、远期神经功能恢复情况。结果CT引导组和非CT引导组在伤椎后凸Cobb角、椎体前缘高度百分比、椎体后缘高度百分比、手术时间、住院时间、手术出血量、术后并发症发生率等方面差异无统计学意义(P>0.05)。CT引导组视觉模拟评分(VAS)、椎管侵占率比非CT引导组降低(P<0.05);CT引导组日本骨科协会(JOA)、生活质量(SF-12量表)评分比非CT引导组高,远期神经功能恢复情况(ASIA脊髓损伤分级)比非CT引导组好(P<0.05)。结论CT引导下椎板间开窗减压治疗单节段A3型腰椎爆裂骨折获得了更好的骨折复位和手术效果,改善了患者的远期神经功能恢复情况和生活质量。
Objective To explore the application effects on CT-guided interlaminar decompression in the operation of single segment A3-type burst fracture of the lumbar spine.Methods A retrospective study was conducted on 56 patients with single-segment A3-type burst fracture of the lumbar spine who received short segment internal fixation in the Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University from January 2017 to June 2019.The patients were divided into CT guided group and no CT guided group according to whether CT guided or not.The perioperative indicators,clinical efficacy,quality of life,imaging parameters,incidence of complications and long-term neurological function recovery of the two groups were evaluated.Results There were no differences between the CT guided group and no CT guided group in terms of Cobb angle,vertebra anterior margin height percentage,vertebra posterior margin height percentage,operative time,length of hospital stay,operative blood loss and postoperative complication rate(P>0.05).Visual analogue scale(VAS)score and spinal canal encroachment rate in the CT guided group was lower than those in the no CT guided group(P<0.05).Compared with the no CT guided group,the CT guided group showed improved performance in terms of Japanese Orthopedic Association score(JOA),quality of life(SF-12 scale),long-term neurological function recovery(Grade of ASIA spinal cord injury)(P<0.05).Conclusion CT-guided decompressive interlaminectomy in the treatment of single segment A3-type burst fracture of the lumbar spine has better fracture reduction and surgical effect,and improves the long-term neurological function recovery and quality of life of the patients.
作者
师蓝达
王玉强
张书豪
赵耀
阮天臣
李朋飞
熊英杰
王庆彬
刘屹林
SHI Lan-da;WANG Yu-qiang;ZHANG Shu-hao;ZHAO Yao;RUAN Tian-chen;LI Peng-fei;XIONG Ying-jie;WANG Qing-bin;LIU Yi-lin(Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2020年第33期6156-6161,共6页
Henan Medical Research
关键词
CT引导
A3型腰椎爆裂骨折
椎板间开窗减压术
CT guide
A3 type burst fracture of lumbar spine
decompressive interlaminectomy
