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1、经伤椎椎弓根螺钉固定治疗胸腰椎骨折的临床体会[摘要]目的探讨经伤椎椎弓根螺钉固定技术治疗胸腰椎骨折的临床效果。方法选取本院2009年2月~2012年12月收治的胸腰椎骨折患者104例,采用经伤椎椎弓根螺钉固定技术治疗,分别于手术前、手术后1周内、末次随访时拍摄胸腰椎X线片、CT片,测量伤椎前缘高度、Cobb角、椎管截面积等,观察骨折愈合,内固定物有无松动、断裂和脊髓神经损伤恢复情况,根据美国脊柱损伤协会(ASIA)分级评定脊髓损伤恢复情况。结果随访11-18个月,手术后1周内伤椎椎体前缘高度、Cobb角与手术前比较,差异冇统计学意义(P0.0
2、5)。随访期间没冇发现椎弓根螺钉系统松动、断裂,随访期间患者脊髓损伤功能恢复1〜2级。结论经伤椎椎弓根螺钉固定技术治疗胸腰椎骨折行Z有效,不仅使伤椎椎体高度恢复满意,矫止后凸畸形,而一且可减少椎弓根螺钉系统松动、断裂,是治疗胸腰椎骨折的有效方法,值得临床推广应用。[关键词]胸腰椎骨折;伤椎;椎弓根螺钉固定[中图分类号]R683:文献标识码]B[文章编号]1674-4721(2014)04(c)-0161-04Clinicalexperieneeofpediclescrewfixationintreatmentofthoracolumbarfr
3、acturesDUYing-junWANGFeiDepartmentofNeurosurgery,theCentralHospitalofJiangjinDistrictinChongqingCity,Chongqing402260,China[Abstract]ObjectiveTostudytheclinicalefficacyofpediclescrewfixationintreatmentofthoracolumbarfractures.Methods104casesofpatientswiththoracolumbarfractur
4、eadmittedinourhospitalfromFebruary2009toDecember2012woresoloctod,andweregivenwithpediclescrewfixationtreatment.Beforesurgery,aweekaftersurgery,thelastfollow-up,thoracolumbarX-ray,CTsliceswasshot;theinjuredvertebraanteriorheight,Cobbangle,spinalandothercross-sectionalareawas
5、measured;fracturehealing,loosefixation,fractureandspinalcordinjuryrecoverywasobserved,therecoveryofspinalcordinjurywasassessedbyASIAclassification.ResultsThepatientswerefollowedupfor11to18monthsafteroperation.Theinjuriesvertebralvertebralheight,Cobbangleafter1weektreatmentc
6、omparedwithbeforesurgery,thedifferencewassignificant(P0.05).Nopediclescrewloosening,fracturewasfoundduringfollow-up.Thefunctioninpatientswithspinalcordinjurywasrecovered1to2duringfollow-upperiod.ConclusionPediclescrewfixationintreatmentofthoracolumbarfractures,notonlymaketh
7、evertebralheightrecoveredsatisfactorily,kyphosiscorrection,butalsoreducethelooseningofpediclescrewsystems,fracture,isaneffectivemethodforthetreatmentofthoracolumbarfractures,anditisworthyofclinicalapplication.[Keywords]Thoracolumbarfracture;Injuredvertebra;Pediclescrewfixat
8、ion胸腰椎骨折是临床常见疾病,常伴有脊髓和(或)马尾神经损伤,骨折可影响脊柱的稳定性,早期治疗对恢复伤椎高度极其巫要,可有效避免迟发性脊髓、神经损伤、创伤性后凸畸