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胸腰椎三维非线性有限元模型的建立
  • ISSN号:0376-2491
  • 期刊名称:中华医学杂志
  • 时间:0
  • 页码:2176-2180
  • 分类:R683.2[医药卫生—骨科学;医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]同济大学附属同济医院脊柱外科,上海200065, [2]新疆医科大学第二附属医院骨科
  • 相关基金:国家自然科学基金(30973034);新疆维吾尔自治区科技支疆项目(201233148)
  • 相关项目:胸腰椎损伤运动功能重建的生物力学研究
中文摘要:

目的 探讨伤椎置钉联合可注射硫酸钙(MIIG)治疗围绝经期胸腰椎骨折的临床疗效.方法 回顾性分析2009年4月至2013年5月同济大学附属同济医院脊柱外科21例围绝经期胸腰椎骨折患者,联合伤椎置钉后路内固定及MIIG前路椎体增强的三维重建术式,比较术后伤椎椎体高度和Cobb角度变化情况,以疼痛视觉模拟评分(VAS)评估患者自觉症状的改变,并随访观察.结果 21例患者经伤椎置钉内固定和MIIGX3手术治疗后成功治愈,平均填充量为4.6 ml.术中渗漏者2例,无严重并发症.患者均获得随访,时间为6~36个月,平均15个月,VAS评分系统显示疼痛症状明显缓解(术前VAS评分平均为7.8分,术后VAS评分平均为2.2分),伤椎椎体高度和Cobb角较术前明显改善,术前分别为45.0%±6.4%和(19.4±4.5)°,末次随访分别为15.4 %±3.9%和(8.7±3.2)°.除2例椎体高度丢失12%外,其余椎体高度平均恢复达正常的85%.结论 围绝经期患者的骨折伤椎,经伤椎置钉联合MIIG的手术治疗,可达到安全有效、复位满意、稳定持久的临床疗效.

英文摘要:

Objective To explore the clinical efficacies of intermediate screws plus injectable calcium sulfate MIIGX3 for thoracolumbar fracture in postmenopausal patients. Methods A total of 21 postmenopausal patients with vertebral compression fractures reconstructed with posterior internal fixation of intermediate screws technique and anterior vertebral augmentation of MIIGX3 technique in three dimension were retrospectively analyzed. The changes of fracture vertebral height and Cobb' s angle were compared. Visual analogue scale (VAS) was performed to evaluate their symptoms. All patients were followed up. Results Intermediate screws surgical technique plus MIIGX3 was successfully performed. The average injection dose was 4. 6 ml. Leakage occurred intraoperatively in two cases. The average follow-up period was 15 (6- 36) months. The VAS system demonstrated that pain decreased significantly (preoperative:7. 8, postoperative:2. 2). The height and Cobb's angle of fractured vertebra improved greatly. The preoperative values were 45.0 ±6.4% and 19.4 ±4.5° and postoperative ones 15.4 ± 3.9% and 8.64 ± 3.18° respectively. There was no occurrence of severe complications related with treatment.Except for 2 patients with a loss of 15% of vertebral height, the average heights of fractured vertebra in other 19 patients recovered to 85% of normal ones. Conclusion Thoracolumbar fracture in postmenopausal patients may be managed satisfactorily by intermediate screws and injectable calcium sulfate technique. Such a technique is both safe and effective. And its stable and durable reduction offers significant improvement.

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期刊信息
  • 《中华医学杂志》
  • 北大核心期刊(2011版)
  • 主管单位:中国科学技术协会
  • 主办单位:中华医学会
  • 主编:
  • 地址:北京市东四西大街42号
  • 邮编:100710
  • 邮箱:nmjc@cma.org.cn
  • 电话:010-85158355 85158180
  • 国际标准刊号:ISSN:0376-2491
  • 国内统一刊号:ISSN:11-2137/R
  • 邮发代号:2-588
  • 获奖情况:
  • 1992年与1996年连续两次在中宣部、国家科委、新闻...,1999年、2003年分别荣获首届国家期刊奖和第二届国...,中国期刊方阵“双高”期刊
  • 国内外数据库收录:
  • 美国化学文摘(网络版),荷兰文摘与引文数据库,荷兰医学文摘,美国生物医学检索系统,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版),中国北大核心期刊(2000版)
  • 被引量:101941