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[1]周成洪,龍亨國,沈萬祥,等.胸腰椎爆裂骨折伴椎間盤損傷形態(tài)學(xué)分型的臨床應(yīng)用研究[J].中醫(yī)正骨,2011,23(11):10-13.
　ZHOU Cheng-hong*,LONG Heng-guo,SHEN Wan-xiang,et al.Research of clinical application of morphological typing of thoracolumbar burst-fracture with intervertebral disc injury[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(11):10-13.
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胸腰椎爆裂骨折伴椎間盤損傷形態(tài)學(xué)分型的臨床應(yīng)用研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年11期
頁碼:
10-13
欄目:
臨床研究
出版日期:
2011-11-30

文章信息/Info

Title:
Research of clinical application of morphological typing of thoracolumbar burst-fracture with intervertebral disc injury
作者:
周成洪; 龍亨國; 沈萬祥; 黃偉; 洪文躍; 劉玖行; 虞杰
浙江省舟山市中醫(yī)骨傷聯(lián)合醫(yī)院,浙江 舟山 316000
Author(s):
ZHOU Cheng-hong*; LONG Heng-guo; SHEN Wan-xiang; et al.*
Zhoushan TCM and Orthopedic Union Hospital,Zhoushan 316000,Zhejiang,China
關(guān)鍵詞:
脊椎骨折 胸椎 腰椎 椎間盤 手術(shù)方式
Keywords:
Spinal fractures;  Thoracic vertebrae;  Lumbar vertebrae;  Intervertebral disk;  Surgical approach
摘要:
目的:探討胸腰椎爆裂骨折伴椎間盤損傷患者,根據(jù)骨折和椎間盤損傷程度不同分型采用不同植骨融合手術(shù)方式的療效。方法:回顧分析我院80例胸腰椎爆裂骨折伴椎間盤損傷患者,根據(jù)胸腰椎爆裂骨折Denis分型和椎間盤損傷Oner分型進(jìn)行分型分組并采用不同手術(shù)方式:A組28例,其中A/Ⅰ型2例、A/Ⅱ型5例、A/Ⅲ型3例、B/Ⅱ型3例、B/Ⅲ型2例、C/Ⅲ型9例、E/Ⅱ型3例、E/Ⅲ型1例,采用單純后路內(nèi)固定傷椎椎體內(nèi)植骨術(shù); B組26例,其中A/Ⅳ型3例、A/Ⅴ型4例、B/Ⅳ型5例、B/Ⅴ型3例、C/Ⅳ型4例、E/Ⅴ型4例,后路內(nèi)固定傷椎椎體內(nèi)植骨加后路植骨融合術(shù); C組14例,其中D/Ⅰ型2例、D/Ⅱ型7例、D/Ⅲ型5,采用后路內(nèi)固定傷椎椎體內(nèi)植骨加后路植骨融合術(shù); D組12例,其中D/Ⅳ型7例、D/Ⅴ型5例,采用后路內(nèi)固定傷椎椎體內(nèi)植骨加椎間植骨融合術(shù)。術(shù)后通過觀察傷椎高度,Cobbs角丟失,三維CT平掃評價植骨愈合情況。結(jié)果:四組患者術(shù)后均獲隨訪,隨訪時間18～36個月,平均24.4個月,所有患者影像學(xué)復(fù)查未見內(nèi)固定松動、斷裂,無假關(guān)節(jié)形成及后凸畸形的發(fā)生,椎體的高度和曲度無明顯丟失,三維CT顯示術(shù)后3個月以上植骨界面完全融合。結(jié)論:術(shù)前對胸腰椎爆裂骨折類型及椎間盤損傷情況的綜合評估,制定有效的固定融合手術(shù)方法,可有效防止內(nèi)固定失敗,復(fù)位丟失和后凸畸形,是治療胸腰椎爆裂骨折伴椎間盤損傷的有效方法。
Abstract:
Objective:To evaluate each operational efficacy after the patients suffered from thoracolumbar burst-fracture with intervertebral disc injury were treated with different surgical approach to graft and fuse bone by typing them according to the degree of fracture and injury of intervertebral disc.Methods:To type and group the 80 patients suffered from thoracolumbar burst-fracture with intervertebral disc injury according to Denis type of thoracolumbar burst-fracture and Oner type of intervertebral disc injury,and to adopt different surgical approach:Group A,28 cases,including 2 cases A/I,5 cases A/II,3 cases A/III,B/III 2 cases,C/III 9 cases,E/II 3 cases,E/III 1cases,o be done the operations of fixing the ill intervertebral bodys internally and grafting bone inside it by the pure posterior approach; Group B,26 cases,including A/IV 3 cases,A/V 4cases,B/IV 5 cases,B/V 3 cases,C/IV 4 cases,E/V 4 cases,to be done the operations of fixing the ill intervertebral bodys internally and grafting and fusing bone by the posterior approach; Group C,14 cases,including D/I 2 cases,D/II 7 cases,D/III 5 cases,to be done the operations of fixing the ill intervertebral bodys internally and grafting and fusing bone by the posterior approach; Group D,12 cases,including D/IV 7 cases,D/V 5 cases,to be done the operations of fixing the ill intervertebral bodys and grafting bone inside it,and grafting and fusing bone between the intervertebral body by the posterior approach.To evaluate the condition of bone graft healing by observing the ill vertebral height,lost of Cobbs horns,three-dimensional CT flat esau after operations.Results:All the 4 groups of cases were followed up for 18-36months,average 24.4 months,no internal fixation loosening or fracture,no occurrence of pseudarthrosis and after protrusion deformity,no obvious lost of the height and curvature of vertebral body were seen in their imaging review.Three-dimensional CT after 3 months showed bone graft interface merged fully.Conclusion:To evaluate comprehensively the types of thoracolumbar burst-fracture and the condition of intervertebral disc injury before operations,then make the efficient surgical approach of fixing and fusing; which can efficiently prevent the failure of internal fixation,reset lost and after prodrusion deformity.It is efficient approach to treat thoracolumbar burst fracture with intervertebral disc injury.

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更新日期/Last Update: 1900-01-01