[1]赵 犀 廖俊城,霍杰钊,邓文仕.椎弓根螺钉长节段固定与短节段固定治疗胸腰段脊柱骨折的临床研究[J].大众科技,2020,22(03):85-87.
 Clinical Study on the Treatment of Thoracolumbar Spine Fracture with PedicleScrew Long Segment Fixation and Short Segment Fixation[J].Popular Science & Technology,2020,22(03):85-87.
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椎弓根螺钉长节段固定与短节段固定治疗胸腰段脊柱骨折的临床研究()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
22
期数:
2020年03
页码:
85-87
栏目:
医药与卫生
出版日期:
2020-03-20

文章信息/Info

Title:
Clinical Study on the Treatment of Thoracolumbar Spine Fracture with PedicleScrew Long Segment Fixation and Short Segment Fixation
作者:
赵 犀1 廖俊城 2 霍杰钊 2 邓文仕 2
(1.广西中医药大学第一附属医院,广西 南宁 530023;2.广西中医药大学,广西 南宁 530001)
关键词:
胸腰段脊柱骨折复位长节段固定短节段固定
Keywords:
thoracolumbar spine fracture Reset short-segment fixation long-segment fixation
文献标志码:
A
摘要:
目的:探讨胸腰段脊柱骨折采用后路椎弓根螺钉长节段内固术与短节段内固定术之间的临床疗效对比。方法:回顾性的选取自 2014 年 3 月至 2016 年 5 月在广西中医药大学第一附属医院院综合骨科住院并进行手术治疗的 80 名资料完整的胸腰段脊柱骨折患者的临床资料,随访时间段 2016 年 2 月至 2017 年 7 月(平均 15.5 个月),以及对两手术组的术中时间、手术前后、术后 1 周及术后 3 个月的椎体前缘高度(%)、Cobb 角(°)、最后一次随访矫形丢失度情况进行回顾性对比分析。结果:所观察的 80 名患者均得到随访且无受试者死亡或者失联,其中长节段内固定有 38 名患者,短节段内固定有 42 名患者。但有 1 例出现断棒(长节段组),1 例出现断钉、有 6 例出现螺钉松动及移位情况(短节段组)。术后立即透视及术后 1 周拍片检查显示 Cobb 角(°)、椎体前缘高度(%)之间进行对比,差异无统计学意义(P>0.05)。术后 3 个月再次对手术的 80 名患者逐一随访发现,长节段内固定与短节段内固定的 Cobb 角(°)、椎体前缘高度(%)、矫正度丢失情况进行对比,差异具有统计学意义。结论:经后方入路短节段内固定与长节段内固定在治疗胸腰段脊柱骨折方面都具有非常显著的效果,术中均能得到很好的复位及畸形矫正,但短节段组椎弓根内固定系统容易出现矫正度丢失、螺钉松动或移位、椎体前缘高度(%)再次发生丢失以及 Cobb 角(°)再次增加等情况。
Abstract:
Objective: To investigate the clinical efficacy of posterior pedicle screw fixation and short segmental internal fixation in thetreatment of thoracolumbar spine fractures. Methods: The clinical data of 80 patients with complete thoracolumbar spine fractures whounderwent surgery and surgery in our hospital from March 2014 to May 2016 were retrospectively selected. The follow-up period wasFebruary 2016 to July 2017 (average 15.5 months), and the intraoperative time, preoperative and postoperative height (%), Cobb angle (°)and the last follow-up loss of orthosis of the two groups were analyzed retrospectively. Results: All 80 patients were followed up and nosubjects died or lost. Among them, 38 patients were fixed in long segment and 42 patients were fixed in short segment. However, there were1 case of broken rods (long segment group), 1 case of broken nails, 6 cases of screw loosening and displacement (short segment group).Immediate postoperative fluoroscopy and 1 week postoperative examination showed Cobb angle (°) and vertebral body height (%) werecompared, the difference was not statistically significant (P>0.05). Three months after the operation, 80 patients were followed up one byone and found that the Cobb angle (°), the height of the anterior edge of the vertebral body (%), and the loss of correction of long segmentinternal fixation and short segment internal fixation were compared, the difference was statistically significant. Conclusion: Short-segmentfixation and long-segment internal fixation through the posterior approach have a very significant effect in the treatment of thoracolumbarspine fractures,, and can get good reduction and deformity correction during operation. However, in the short segment group, the pedicleinternal fixation system is prone to the situation of loss of correction, loosening or displacement of screws, loss of anterior height ofvertebral body (%), loss of Cobb angle (°)again, and further increase and so on.

参考文献/References:

[1] 陈仲强,刘忠军,党耕町主编.脊柱外科学[M]. 北京:人民卫生出版社,2013.[2] Kim H Y, Kim H S, Kim S W, et al. Short segment screwfixation with- out fusion for unstable thoracolumbar andlumbar burst fracture: a prospective study on selectiveconsecutive patients[J]. Journal of Korean NeurosurgicalSociety, 2012, 51(4): 203-207.[3] Mohanty S P, Bhat S N, Ishwara-Keerthi C. The effect ofposterior in-strumentation of the spine on canaldimensions and neurological re- covery in thoracolumbarand lumbar burst fractures[J]. Musculoskeletal Surgery,2011, 95(2): 101-106.[4] 秦入结,李垠,宋波,等. 手术入路的选择对胸腰椎爆裂骨折疗效的影响[J]. 临床骨科杂志,2008,11(2):115-118.[5] 邹守平,谭小云,黄强,等. 延伸后路钉棒内固定修复青年型胸腰椎单纯屈曲压缩性骨折:改善矫形复位效率[J]. 中国组织工程研究,2016,20(22): 3242-3248.[6] 邵朋, 高清元,赵东. 胸腰椎爆裂骨折不同手术方式的临床分析[J]. 中国骨与关节损伤杂志,2014,29 (5):433-435.[7] Leferink V J, Zimmerman K W, Veldhuis E F, et al.Thoracolumbar spinal fractures:radiological results oftranspedicular fixation combined with transpedicularcancellous bone graft and posterior fusion in 183patients[J]. Euroean Spine Journal, 2001,10(6): 517-23.[8] Knop C, Fabian H F, Bastion L, et al. Late resultsthoracolumbar fracture after posterior instrumentation andtranspedicular bone grafting[J]. Spine, 2001, 26(1):89-99.[9] Kramer D L, Rodgers W B, Mansfield F L.Transpedicular Instrumentation and Short-SegmentFusion of Thoracolumbar Fractures: A Prospective StudyUsing a Single Instrumentation System[J]. Journal ofOrthopaedic Trauma, 1995, 9(6): 499-506.[10] Lazaro B C R, Deniz F E, Brasiliense L B C, et al.Biomechanics of thoracic short versus long fixation after3-column injury[J]. Journal of Neurosurgery Spine, 2011,14(2): 226-234.[11] 王鹏. 胸腰段椎体骨折后路内固定术后伤椎骨缺损的生物力学有限元分析[D]. 扬州: 扬州大学,2017.

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备注/Memo

备注/Memo:
【收稿日期】2020-01-09【作者简介】赵犀(1993-),男,广西中医药大学在读硕士研究生,研究方向为脊柱脊髓疾病的诊治研究。
更新日期/Last Update: 2020-05-25