智能化体外充气复位联合经皮椎弓根螺钉固定治疗胸腰段爆裂型骨折
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作者Author单位AddressE-Mail
邵荣学 SHAO Rong-xue 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
陈宝英 CHEN Bao-ying 浙江中医药大学附属第三医院, 浙江 杭州 300005  
周辉 ZHOU Hui 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China huizhou2016@yahoo.com 
潘浩 PAN Hao 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
乐军 YUE Jun 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
陈惠国 CHEN Hui-guo 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
杨贺杰 YANG He-jie 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
胡庆丰 HU Qing-feng 杭州市中医院, 浙江 杭州 310007 Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, 310007, Zhejiang, China  
全仁夫 QUAN Ren-fu 浙江中医药大学附属江南医院, 浙江 杭州 311201  
期刊信息:《中国骨伤》2018年,第31卷,第8期,第698-702页
DOI:10.3969/j.issn.1003-0034.2018.08.003
基金项目:
中文摘要:

目的:评价智能化体外充气复位联合经皮椎弓根螺钉固定治疗胸腰段爆裂型骨折的临床效果。

方法:回顾性分析2013年1月至2015年12月收治的22例单节段胸腰段爆裂型骨折患者,其中男12例,女10例,年龄32~56(42.4±8.6)岁。22例患者术前均采用自行研制的智能化充气复位仪体外复位,然后行经皮椎弓根螺钉固定治疗,通过视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、脊柱后凸畸形角度(Cobb角)及椎体前缘高度对患者手术前后的临床特征进行评价并观察其临床疗效。

结果:所有患者获得随访,时间1~2.5年,平均18个月。22例骨折均获得愈合,未出现椎弓根螺钉松动、移位、断裂及脊柱后凸畸形等并发症。术前、术后1周及末次随访腰痛VAS评分分别为7.82±0.85,3.09±0.92,1.05±0.72;ODI评分为84.2±11.2,46.3±9.0,12.2±4.3;后凸Cobb角为(16.3±5.4)°,(3.7±2.2)°,(5.5±2.6)°;椎体前缘高度为(59.5±7.8)%,(86.9±6.0)%,(83.5±5.5)%。VAS评分和ODI评分在术前、术后1周及末次随访,两两时间比较差异有统计学意义(P<0.05)。后凸Cobb角和伤椎前缘高度,术后1周、末次随访与术前比较差异有统计学意义(P<0.05),术后1周和末次随访比较差异无统计学意义。

结论:智能化体外充气复位联合经皮椎弓根螺钉固定术具有复位可靠、创伤小、骨折愈合率高和并发症少等优点,是胸腰段爆裂型骨折较好的治疗方案,值得临床推广应用。
【关键词】胸椎  腰椎  脊柱骨折  骨牵引复位法  椎弓根螺钉  外科手术,微创性
 
Treatment of thoracolumbar burst fractures with intelligent inflated reduction combined with percutaneous pedicle screw fixation
ABSTRACT  

Objective:To evaluate the clinical outcome of intelligent inflated reduction combined with percutaneous pedicle screw fixation in treating thoracolumbar burst fractures.

Methods:The clinical data of 22 patients with thoracolumbar burst fractures of single segment treated from January 2013 to December 2015 were retrospectively analyzed. There were 12 males and 10 females,aged from 32 to 56 years old with an average of (42.4±8.6) years. Self-made intelligent pneumatic reset instrument was applied to 22 cases under anaesthesia reduction,and then percutaneous pedicle screw fixation was performed. Clinical features were observed and the clinical effects were evaluated by VAS,ODI,kyphotic angle (Cobb angle) and the injured vertebral anterior border height before and after operation.

Results:All the patients were followed up from 1 to 2.5 years with an average of 18 months. All fractures obtained bone healing,no complications such as loosening,displacement,breakage of pedicle screw and kyphosis were found. Preoperative,1 week postoperative,and final follow-up,VAS scores of lumbar pain were 7.82±0.85,3.09±0.92,1.05±0.72;ODI scores were 84.2±11.2,46.3±9.0,12.2±4.3;Cobb angle were (16.3±5.4)°,(3.7±2.2)°,(5.5±2.6)°;the injured vertebral anterior border heights were (59.5±7.8)%,(86.9±6.0)%,(83.5±5.5)%,respectively. There was significant differences in VAS,ODI scores between any two times(P<0.05). At 1 week postoperative and final follow-up,Cobb angle,injuried vertebral anterior border height were obviously improved (P<0.05),and there was no significant difference between postoperative 1 week and final follow-up (P>0.05).

Conclusion:It is safe and feasible surgical technique that intelligent inflated reduction combined with percutaneous pedicle screw fixation for thoracolumbar burst fractures. It has advantage of little trauma,reliable fixation,and less complication,etc. Therefore,it is a better choice for single-segment thoracolumbar burst fractures.
KEY WORDS  Thoracic vertebrae  Lumbar vertebrae  Spinal fractures  Skeletal tractiong reposition  Pedicle screw fixation  Surgical procedures,minimally invasive
 
引用本文,请按以下格式著录参考文献:
中文格式:邵荣学,陈宝英,周辉,潘浩,乐军,陈惠国,杨贺杰,胡庆丰,全仁夫.智能化体外充气复位联合经皮椎弓根螺钉固定治疗胸腰段爆裂型骨折[J].中国骨伤,2018,31(8):698~702
英文格式:SHAO Rong-xue,CHEN Bao-ying,ZHOU Hui,PAN Hao,YUE Jun,CHEN Hui-guo,YANG He-jie,HU Qing-feng,QUAN Ren-fu.Treatment of thoracolumbar burst fractures with intelligent inflated reduction combined with percutaneous pedicle screw fixation[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(8):698~702
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