新型外固定器联合椎体植骨在相邻双节段胸腰椎骨折中的应用
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作者Author单位AddressE-Mail
王程 WANG Cheng 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China  
阙伊辰 QUE Yi-chen 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China  
宋西正 SONG Xi-zheng 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China  
晏怡果 YAN Yi-guo 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China  
陈洋 CHEN Yang 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China  
王文军 WANG Wen-jun 南华大学附属第一医院脊柱外科, 湖南 衡阳 421001 Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang 421001, Hunan, China wwj1202@hotmail.com 
期刊信息:《中国骨伤》2018年,第31卷,第8期,第714-717页
DOI:10.3969/j.issn.1003-0034.2018.08.006
基金项目:湖南省重点研发计划(编号:2017SK2104);湖南省卫生计生委科研计划课题项目(编号:A2017016);湖南省脊柱微创临床医学研究中心(编号:2017SK4004)
中文摘要:

目的:探讨脊柱新型外固定器在无神经功能障碍相邻双节段胸腰椎骨折微创治疗中的临床疗效。

方法:对2013年1月至2015年8月收治的28例无神经功能障碍相邻双节段胸腰椎骨折患者的临床资料进行回顾性分析,其中男17例,女11例;年龄19~55岁,平均(37.5±10.3)岁。依据骨折AO分型,均为A型骨折,其中T10,11 2例,T11,12 3例,T12L1 9例,L1,2 4例,L2,3 5例,L3,4 4例,L4,5 1例。28例均行脊柱新型外固定联合经皮椎体植骨术治疗,记录手术时间、术中出血及并发症情况,影像学观察手术前后﹑外固定拆除前和末次随访时的椎体前缘高度百分比变化、骨愈合情况,依据手术前后及随访期间VAS评分评估临床疗效。

结果:28例手术顺利,均获得随访,时间13~32个月,平均(24.5±3.5)个月。术前椎体前缘高度百分比和VAS评分与术后3 d、外固定器拆除前及末次随访时比较差异均有统计学意义(P<0.05);末次随访椎体前缘高度百分比与术后3 d及外固定器拆除前比较差异无统计学意义(P>0.05);而VAS评分则呈现逐降下降的趋势。术后2例出现螺钉松动,1例钉道感染,余无其他并发症。

结论:采用脊柱新型外固定器治疗无神经功能障碍相邻双节段胸腰椎骨折能获得满意的临床疗效,是一种有效的微创手术方式,具有一定的临床应用价值。
【关键词】脊柱外固定器  胸椎  腰椎  脊柱骨折  外科手术,微创性  骨移植
 
New external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting for the treatment of two-segment thoracolumbar fractures
ABSTRACT  

Objective:To investigate the clinical results of new external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting in the treatment of two-segment thoracolumbar fractures without neural dysfunction.

Methods:The clinical data of 28 patients with two-segment thoracolumbar fractures without neural dysfunction treated from January 2013 to August 2015 were retrospectively analyzed. There were 17 males and 11 females,with a mean age of(37.5±10.3) years (ranging from 19 to 55 years). According to fracture AO classification,all 28 cases were type A,including 2 cases of T10,11, 3 cases of T11,12,9 cases of T12-L1, 4 cases of L1,2,5 cases of L2,3,4 cases of L3,4,1 case of L4,5. All 28 patients received treatment of new external spinal skeletal fixation and percutaneous injury vertebra bone grafting. Operation time,intraoperative bleeding and related complications were recorded. The informations of vertebral anterior border height percentage and bone fusion were observed by radiography before and after operation,before removed external fixation and final follow-up. Visual analogue scale(VAS) was used to evaluate the clinical effects.

Results:All the patients were followed up for 13 to 32 months with an average of (24.5±3.5) months. There was significant difference by the time of 3 days postoperatively,before removed external fixation,final follow-up comparing with the preoperative in vertebral anterior border height percentage and VAS score(P<0.05). There was no significant difference in vertebral anterior border height percentage by the time of 3 days postoperatively,before removed external fixation comparing with final follow-up(P>0.05). While the VAS score showed a gradually declining trend,screw lossening ocurred in 2 cases and nail tracker infection occurred in 1 case after operation,and no other complications were found.

Conclusion:New external spinal skeletal fixation and percutaneous injury vertebra bone grafting can got satisfactory clinical effect in treating two-segment thoracolumbar fractures without neural dysfunction,which is an effective method of minimally invasive surgery.
KEY WORDS  External spinal skeletal fixation  Thoracic vertebrae  Lumbar vertebrae  Spinal fractures  Surgical procedures,minimally invasive  Bone transplantation
 
引用本文,请按以下格式著录参考文献:
中文格式:王程,阙伊辰,宋西正,晏怡果,陈洋,王文军.新型外固定器联合椎体植骨在相邻双节段胸腰椎骨折中的应用[J].中国骨伤,2018,31(8):714~717
英文格式:WANG Cheng,QUE Yi-chen,SONG Xi-zheng,YAN Yi-guo,CHEN Yang,WANG Wen-jun.New external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting for the treatment of two-segment thoracolumbar fractures[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(8):714~717
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