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[1]鄭安華,徐正生,方崇斌.椎弓根螺釘固定聯(lián)合與非聯(lián)合傷椎置釘治療單節(jié)段胸腰椎骨折的對(duì)比研究[J].中醫(yī)正骨,2012,24(12):20-22.
　ZHENG An-hua*,XU Zheng-sheng,FANG Chong-bin..A retrospective comparison of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):20-22.
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椎弓根螺釘固定聯(lián)合與非聯(lián)合傷椎置釘治療單節(jié)段胸腰椎 骨折的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年12期
頁碼:
20-22
欄目:
脊柱損傷
出版日期:
2012-12-20

文章信息/Info

Title:
A retrospective comparison of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures
作者:
鄭安華; 徐正生; 方崇斌
浙江省臺(tái)州市中醫(yī)院,浙江 臺(tái)州 318000
Author(s):
ZHENG An-hua*; XU Zheng-sheng; FANG Chong-bin.
*Traditional Chinese Medical Hospital of Taizhou City,Taizhou 318000,Zhejiang,China
關(guān)鍵詞:
脊柱骨折 胸椎 腰椎 內(nèi)固定器 治療; 臨床研究性
Keywords:
Spinal fractures;  Thoracic vertebrae;  Lumbar vertebrae;  Internal fixators;  Therapies; investigational
摘要:
目的:評(píng)價(jià)椎弓根螺釘固定聯(lián)合與非聯(lián)合傷椎置釘治療單節(jié)段胸腰椎骨折的臨床療效和安全性。方法:回顧性分析76例單節(jié)段胸腰椎骨折患者的病歷資料,采用聯(lián)合傷椎置釘治療者39例(A組),采用非聯(lián)合傷椎置釘治療者37例(B組)。比較2組患者術(shù)前及術(shù)后1年的傷椎高度比[傷椎高度比=(傷椎前緣高度÷傷椎上下椎體前緣平均高度)×100%]、Cobb's角及腰痛視覺模擬評(píng)分,并記錄患者術(shù)后及隨訪期間并發(fā)癥的發(fā)生情況。結(jié)果:①傷椎高度比。2組患者術(shù)前傷椎高度比[(45.90±15.30)%,(46.80±16.30)%]比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.721,P=0.712); A組患者術(shù)后1年與術(shù)前傷椎高度比的差值[(40.30±12.60)%]大于B組[(29.60±15.80)%],差異有統(tǒng)計(jì)學(xué)意義(t=3.273,P=0.004)。②Cobb's角。2組患者術(shù)前Cobb's角[(17.40°±3.40°),(16.90°±3.20°)]比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.559,P=0.657); A組患者術(shù)后1年與術(shù)前Cobb's角的差值(11.20°±2.80°)大于B組(6.20°±2.60°),差異有統(tǒng)計(jì)學(xué)意義(t=3.974,P=0.001)。③腰痛評(píng)分。2組患者術(shù)前腰痛視覺模擬評(píng)分[(7.20±2.30)分,(7.40±2.50)分]比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.363,P=0.733); A組患者術(shù)后1年與術(shù)前腰痛視覺模擬評(píng)分的差值[(5.30±3.20)分]大于B組[(3.60±1.30)分],差異有統(tǒng)計(jì)學(xué)意義(t=2.114,P=0.032)。④并發(fā)癥。2組患者均未出現(xiàn)切口感染、深部感染、血管神經(jīng)損傷及內(nèi)固定失敗等并發(fā)癥。結(jié)論:椎弓根螺釘固定聯(lián)合傷椎置釘固定在恢復(fù)單節(jié)段胸腰椎骨折患者傷椎高度、糾正后凸畸形及緩解腰椎疼痛方面優(yōu)于非聯(lián)合傷椎置釘固定,而且安全性與后者相當(dāng)。
Abstract:
Objective:To evaluate the clinical curative effect and safety of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures.Methods:The medical records of 76 patients with thoracolumbar single-segment fractures were analyzed retrospectively,39 patients(group A)underwent pedicle screw fixation integrated with pedicle fixation at the level of the fracture,while the others(group B)underwent pedicle screw fixation nonintegrated with pedicle fixation at the level of the fracture.The fractured vertebral body height ratio[(anterior height of fractured vertebral body/average anterior height of upper-lower fractured vertebral body)×100%],Cobb's angle and visual analogue scores(VAS)of lumbago were compared between the two groups before the operation and 1 year after the operation,and the complications in the postoperative and follow-up periods were recorded.Results:①Fractured vertebral body height ratio:there was no statistical difference in pre-operative height ratio of fractured vertebral body[(45.90±15.30)%,(46.80±16.30)%]between the 2 groups(t=0.721,P=0.712); while difference value of fractured vertebral body height ratio between 1 year post-operation and pre-operation for group A[(40.30±12.60)%]was greater than that of group B[(29.60±15.80)%]and there was statistical difference between them(t=3.273,P=0.004).②Cobb's angle:there was no statistical difference in pre-operative Cobb's angle[(17.40°±3.40°),(16.90°±3.20°)]between the 2 groups(t=0.559,P=0.657); while Cobb's angle D-value between 1 year post-operation and pre-operation of group A(11.20°±2.80°)was greater than that of group B(6.20°±2.60°)and there was statistical difference between them(t=3.974,P=0.001).③Lumbago VAS:there was no statistical difference in pre-operative lumbago VAS[(7.20±2.30),(7.40±2.50)]between the 2 groups(t=0.363,P=0.733); while D-value of lumbago VAS between 1 year post-operation and pre-operation of group A(5.30±3.20 was greater than that of group B(3.60±1.30)and there was statistical difference between them(t=2.114,P=0.032).④Complications:no complications such as incision infection,deep infection,neurovascular injury and failed internal fixation were found in the 2 groups.Conclusion:The therapy of pedicle screw fixation integrated with pedicle fixation at the level of the fracture has better effect on the aspects of fractured vertebral body height recovery,kyphotic deformity correction and pain relief in lumbar spine for the patients with thoracolumbar single-segment fractures compared with the therapy which nonintegrated with pedicle fixation at the level of the fracture,and the two methods have similar safety.

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更新日期/Last Update: 2012-12-20