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短节段椎弓根螺钉固定结合椎体增强术治疗胸腰椎爆裂性骨折
  • ISSN号:0253-2352
  • 期刊名称:中华骨科杂志
  • 时间:0
  • 页码:927-931
  • 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]上海市嘉定区中心医院骨科
  • 相关基金:国家自然科学基金(30973034);上海市科委科技攻关重点项目(08411952200)
  • 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:

目的探讨短节段椎弓根螺钉固定结合椎体增强术治疗胸腰椎爆裂性骨折的疗效。方法2006年11月至2009年9月采用短节段椎弓根螺钉固定结合自固化硫酸钙骨水泥椎体增强术治疗且有完整随访资料的胸腰椎爆裂性骨折患者37例,男21例,女16例;年龄39-60岁,平均47-3岁。术后评估伤椎前缘高度比、矢状面Cobb角、神经功能恢复、内固定失败率、疼痛视觉模拟评分及Oswestu功能障碍指数。结果随访14-37个月,平均19个月。无内固定失败。16例术前神经功能部分损害者12例完全恢复,无神经功能损害加重。自固化硫酸钙平均于术后3个月开始吸收,椎体骨折术后5个月内愈合。伤椎前缘高度比由术前55.40%±9.79%恢复至术后85.46%±6.56%,最终维持在82.35%±7.48%;矢状面Cobb角由术前22.45°±7.74°恢复至术后6.86°±5.27°,最终维持在9.66°±5.88°。末次随访时疼痛视觉模拟评分平均1.2,Oswestu功能障碍指数平均20.4。结论短节段椎弓根螺钉固定结合自固化硫酸钙骨水泥椎体增强术治疗胸腰椎爆裂性骨折安全、简便,能有效防止椎体高度丢失及进行性后凸畸形。

英文摘要:

Objective To evaluate the efficacy of short-segment transpedicular fixation combined with augmentation vertebroplasty in treatment of thoracolumbar burst fractures. Methods From November 2006 to September 2009, 37 patients with thoracolumbar burst fracture were admitted and received transpedicular fixation combined with calcium sulfate cement augmentation vertebroplasty, and the clinical data including fracture types, complications and following-up results were collected for analysis. The multi- method evaluation strategies involved the anterior vertebral body height, the sagittal Cobb's angle, the restoration of nervous function, internal fixation failure, visual analogue scale (VAS) and Oswestry disability index (ODI) were retrospective analyzed. Results All patients were followed up for average 19 months (range, 14-37). There were no internal fixation failure, loss of reduction, neurological complications in all the patients. In 16 patients with partial neurologic deficits, 14 initially improved at the final follow-up, with no deterioration of neurologic functions. The mean time of calcium sulfate cement obvious absorption and union was 3 months and 5 months postoperatively, respectively. The anterior vertebral body height was 55.40% before surgery and 85.46% after surgery on average, ended up with 82.35%. The sagittal Cobb's angle was improved from 22.45° to 6.86°, ended up with 9.66° on average. The mean VAS and ODI at the final follow- up were respectively 1.2 and 20.4 on average. Conclusion Short-segment transpedicular fixation combined with augmentation vertebroplasty appears to be effective in achieving stable biomechanics with high security, which seems to be a feasible option in the management of thoracolumbar burst fractures.

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期刊信息
  • 《中华骨科杂志》
  • 中国科技核心期刊
  • 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:天津市河西区解放南路406号
  • 邮编:300211
  • 邮箱:gktougao@126.com
  • 电话:022-28334734 28278929
  • 国际标准刊号:ISSN:0253-2352
  • 国内统一刊号:ISSN:12-1113/R
  • 邮发代号:6-17
  • 获奖情况:
  • 中国期刊方阵“双效”期刊
  • 国内外数据库收录:
  • 俄罗斯文摘杂志,美国化学文摘(网络版),英国农业与生物科学研究中心文摘,波兰哥白尼索引,美国剑桥科学文摘,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:67445