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中国现代手术学杂志  2017, Vol. 21 Issue (5): 387-390    DOI: 10.16260/j.cnki.1009-2188.2017.05.015
  临床论著 |
经伤椎置钉手术治疗单节段胸腰椎骨折的临床研究
秦卫,胡丹,司卫兵,焦健
苏州市立医院北区骨科,苏州 215000
Clinical Study on 40 Cases of Monosegmental Fixation for the Treatment of Single Thoracolumbar Vertebral Fracture
QIN Wei, HU Dan, SI Weibing, JIAO Jian
Department of Orthopedics,North Branch, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu, China
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摘要 目的探讨经伤椎置钉手术治疗单节段胸腰椎骨折患者的临床效果。方法选取2012年1月至2015年7月我院接诊的单节段胸腰椎骨折患者80例,采用随机数字表法分为两组,每组各40例。对照组患者给予后路短节段椎弓根钉跨伤椎内固定术治疗,观察组给予经伤椎置钉手术治疗。比较两组患者治疗手术参数以及治疗后的Cobb角、椎体压缩百分比、椎管矢状径占位率、神经功能障碍恢复,对比术后1年内固定失败率。结果两组患者的手术时间、住院时间以及失血量进行比较,差异无统计学意义(P>0.05);观察组患者的Cobb角、椎体压缩百分比及椎管矢状径占位率为(4.56°±0.78°、12.45±1.02、4.58±0.23),明显低于对照组患者(6.78°±1.02°、16.47±2.98、6.85±0.49), 差异具有统计学意义(P<0.05); 术后, 患者的神经功能障碍分级均有改善, 两组对比,差异无统计学意义 (P>0.05); 治疗后, 观察组患者术后1年内固定总失败率为2.5%, 低于对照组患者的17.5%,差异具有统计学意义(P<0.05)。结论单节段胸腰椎骨折选用经伤椎置钉手术治疗,可提高远期固定效果,降低椎体坍塌、内固定失败的发生,促进患者术后早期康复。
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QIN Wei
HU Dan
SI Weibing
JIAO Jian
关键词:  脊柱骨折  胸椎  腰椎  内固定器    
Abstract: ObjectiveTo investigate the clinical effect of monosegmental fixation for the treatment of single thoracolumbar vertebral fracture.Methods80 cases with single thoracolumbar vertebral fracture were selected from January 2012 to July 2015 in our hospital. All the single thoracolumbar fracture patients were randomly divided into two groups, with 40 patients in each. The patients in the observation group received pedicle screw fixation via the monosegmental vertebra and the patients in the control group were treated with posterior short segment pedicle screw fixation across the injured vertebra. The surgical parameters, such as the Cobb angle, the percentage of vertebral compression, the sagittal diameter of vertebral canal and the recovery of neurological deficits were compared between the two groups. The rate of fixation failure in one year after operation was compared as well.ResultsOperation time, length of hospital stay and intraoperative blood loss of the two groups were compared, and the difference was not statistically significant (P>0.05). The Cobb angle vertebral compression percentage and sagittal diameter of spinal canal occupying rate of the observation group was significantly lower than that of control group, which was (4.56°±0.78°, 12.45±1.02, 4.58±0.23) VS (6.78°±1.02°, 16.47±2.98, 6.85±0.49). The differences were statistically significant (P<0.05). The neurological function of the patients improved, and there was no significant difference between the two groups (P>0.05). The total failure rate of the observation group within one year was 2.5%, which was lower than 17.5% of the control group, and the difference was statistically significant (P<0.05).Conclusion It can improve longterm fixation effect, reduce vertebral collapse and the internal fixation failure rate, and promote early postoperative rehabilitation of the pedicle screw fixation via the injured vertebra for the treatment of single thoracolumbar vertebral fracture.
Key words:  spinal fractures    thoracic vertebrae    lumbar vertebrae    fixator, internal
               出版日期:  2017-10-26      发布日期:  2018-05-25      期的出版日期:  2017-10-26
ZTFLH:  R683.2  
基金资助: 苏州市卫生和计划生育委员会建设项目(编号:Szzxj201506),受苏州市临床医学中心资助。
通讯作者:  胡丹,男,46岁,苏州市立医院北区骨科主任医师。   
作者简介:  秦卫,男,42岁,苏州市立医院北区骨科副主任医师。
引用本文:    
秦卫,胡丹,司卫兵,焦健. 经伤椎置钉手术治疗单节段胸腰椎骨折的临床研究[J]. 中国现代手术学杂志, 2017, 21(5): 387-390.
QIN Wei, HU Dan, SI Weibing, JIAO Jian. Clinical Study on 40 Cases of Monosegmental Fixation for the Treatment of Single Thoracolumbar Vertebral Fracture. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 387-390.
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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2017.05.015  或          http://www.surgerychina.com/CN/Y2017/V21/I5/387
[1] 李长青, 张伟, 常献, 等. 小切口减压结合经皮椎弓根螺钉内固定治疗伴神经功能损害的胸腰椎骨折[J]. 中国脊柱脊髓杂志,2014,22(5):395399.
[2] Cappuccio M, De Iure F, Amendola L, et al. Vertebral body compression fracture after percutaneous pedicle screw removal in a young man[J]. J Orthop Traumatol, 2015,16(4):343345. doi: 10.1007/s1019501403285.
[3] 张伟, 李海音, 李杰, 等. 微创减压联合经皮固定与传统开放手术治疗伴神经损害胸腰椎骨折的疗效比较[J]. 中国脊柱脊髓杂志,2015,25(5):420426.
[4] 陈彦, 初同伟, 杨波, 等. 经伤椎置钉短节段固定治疗胸腰段脊柱骨折的疗效分析[J]. 重庆医学,2016,45(13):18411843.
[5] 胡磊, 丁伟, 余俊, 等. 重组人骨形态发生蛋白2联合椎体内植骨经伤椎后路置钉治疗A型胸腰椎骨折的效果[J]. 中华创伤杂志,2017,33(8):737742.
[6] 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.
[7] 韩雷, 全仁夫, 孙观荣, 等. 经皮椎弓根螺钉结合伤椎置钉与骨水泥强化治疗中老年胸腰椎骨质疏松性压缩骨折的疗效比较[J]. 中华创伤杂志,2017,33(3):213218.
[8] Samdani AF, Asghar J, Miyanji F, et al. Recurrence of rib prominence following surgery for adolescent idiopathic scoliosis with pediclescrews and direct vertebral body derotation[J]. Eur Spine J, 2015,24(7):15471554. doi: 10.1007/s005860143716x.
[9] 云华. 对比单侧伤椎置钉与跨伤椎椎弓根内固定治疗胸腰椎骨折的效果[J]. 浙江创伤外科,2017,22(2):336338.
[10] Lefranc M, Peltier J. Accuracy of thoracolumbar transpedicular and vertebral body percutaneous screw placement: coupling the Rosa? Spine robot with intraoperative flatpanel CT guidancea cadaver study[J]. J Robot Surg, 2015,9(4):331338. doi: 10.1007/s117010150536x.
[11] 曾忠友, 张建乔, 金才益, 等. 胸腰椎脊柱骨折不同固定方式疗效对比分析[J]. 中华创伤杂志, 2012,28(2):149154.
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