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[1]王鑫鑫,李林軍,劉大棟.改良椎間截骨術(shù)治療胸腰椎陳舊性骨折后凸畸形[J].中醫(yī)正骨,2019,31(06):63-66.
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改良椎間截骨術(shù)治療胸腰椎陳舊性骨折后凸畸形()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年06期
頁碼:
63-66
欄目:
臨床報道
出版日期:
2019-06-20

文章信息/Info

作者:
王鑫鑫; 李林軍; 劉大棟
(周口市中心醫(yī)院,河南 周口 466000)
關(guān)鍵詞:
脊柱骨折;  胸椎;  腰椎;  截骨術(shù);  脊柱后凸
摘要:
目的:觀察改良椎間截骨術(shù)治療胸腰椎陳舊性骨折后凸畸形的臨床療效及安全性。方法:2014年1月至2017年5月,采用改良椎間截骨術(shù)治療胸腰椎陳舊性骨折后凸畸形患者20例,男5例、女15例。年齡52～68歲,中位數(shù)58歲。后凸頂椎位于T126例、L18例、L23例、L33例。所有患者后凸畸形Cobb角均大于20°,且呈漸進(jìn)性加重,伴有畸形處疼痛,經(jīng)大于6個月非手術(shù)治療無效。術(shù)后隨訪觀察截骨面骨愈合、后凸畸形矯正、腰部疼痛緩解、腰椎功能恢復(fù)及并發(fā)癥發(fā)生情況。結(jié)果:本組患者手術(shù)時間(194.0±15.4)min,術(shù)中出血量(777.0±28.0)mL。所有患者均獲隨訪,隨訪時間18～48個月,中位數(shù)36個月。截骨面均骨性融合。矢狀面Cobb角,術(shù)前33.7°±4.6°、術(shù)后3個月5.3°±2.5°、末次隨訪6.1°±3.3°; 腰部疼痛視覺模擬量表評分,術(shù)前(7.1±1.3)分、術(shù)后3個月(3.1±1.6)分、末次隨訪(2.8±1.6)分; Oswestry功能障礙指數(shù),術(shù)前(74.3±13.0)%、術(shù)后3個月(21.3±5.8)%、末次隨訪(17.3±4.1)%。1例出現(xiàn)一過性下肢肌力下降,給予激素和營養(yǎng)神經(jīng)藥物治療,出院1個月后下肢肌力恢復(fù)正常; 1例出現(xiàn)大腿前外側(cè)放射痛,給予激素和營養(yǎng)神經(jīng)藥物治療,2周后癥狀明顯緩解; 均無椎弓根釘松動、斷裂及假關(guān)節(jié)形成等并發(fā)癥發(fā)生。結(jié)論:采用改良椎間截骨術(shù)治療胸腰椎陳舊性骨折后凸畸形,術(shù)中出血少,截骨面骨愈合率高,能矯正后凸畸形、緩解腰部疼痛、促進(jìn)腰椎功能恢復(fù),并發(fā)癥少,值得臨床推廣應(yīng)用。

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(收稿日期:2018-11-14 本文編輯:時紅磊)
更新日期/Last Update: 1900-01-01