脊柱外固定器治疗胸腰椎骨折的疗效观察

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1、脊柱外固定器治疗胸腰椎骨折的疗效观吴威强R远明黄中飞彭金贵平南同安骨伤医院脊柱科广西医科大学第二附属医院骨科广西中医药大学附属瑞康医院骨脊柱科摘要：目的探讨新型脊柱外固定器联合伤椎椎体成形术或伤椎植骨治疗胸腰椎骨折的临床疗效。方法回顾分析该院2011-072016-07住院治疗221例胸腰椎骨折患者的情况。方法是先应用脊柱外固定器进行骨折复位后分别行椎体成形术（骨质疏松性骨折）或伤椎植骨术（外伤骨折）。依据影像学资料计算术前、术后和末次随访伤椎高度丢失率、后lniCobb角及视觉模拟评分（visualanaloguescale,VAS）。结果221例患者在行手术治

2、疗后及末次随访时的伤椎高度丢失率、后凸Cobb角及视觉模拟评分均较治疗前有明显改善，差异有统计学意义（P<0.05）,末次随防结果与治疗后各项指标对比差异无统计学意义。骨水泥渗漏13例，椎体高度丢失11例，无并发神经损伤。无螺钉松动及螺钉断裂病例。结论应用脊柱外I古I定器治疗胸腰椎骨折创伤小，且安全有效。关键词：胸腰椎;骨折;脊柱外固定;作者简介：吴威强（1977-）,男，大学本科，学士学位，主治医师，研究方向:脊柱外科疾病的诊治。E-mail:wqiangl63@163.com作者简介：陈远明（1971-），男，医学博士，主任医师，研究方向：脊柱微创。E-mai

3、l:rkyygk@163.com收稿日期：2017-05-03基金：广西壮族自治区教育厅高校科研项目（编号:ZD2014066）ClinicaleffectofspinalexternalfixationinstrumentsontreatmentofthoracolumbarfacturesWUWei-qiangCHENYuan-mingHUANGZhong-feiDepartmentofSpinalSurgery,TonganOrthopedicHospitalofPingnonCounty;Abstract：ObjectiveToexploretheclin

4、icaleffectofanewapproachofspinalexternalfixationcombinedwithvertebroplastyorvertebralbonegraftonthoracolumbarfracturcs.MethodsTheclinicaldataof221patientswiththoracolumbarfractureswerecollectedinourhospitalfromJuly2011toJuly2016andwereretrospectivelyanalyzed.Externalfixationinstrument

5、swereinitiallyusedforfracturereductionandthenvertebroplasty(forosteoporoticfracture)orvertebreilbonegraft(fortraumaticfractures)wasperformed.Theinjuryvertcbralheightsatthetimeofpreoperation,postoperationandthefinalfollow-upaccordingtotheradiographicdata,kyphoticCobbAngleandvisualanalo

6、guescale(VAS)wererecorded.ResultsAl1the221patientsimprovedsignificantlyaftersurgeryandatthetimeofthefinalfollow-upininjuredvertebralheight,kyphoticCobbAngleandvisualanaloguescale(P<0.05).TherewerenosignificantdifferencesintheindicatorsbetweenthepostoperativeresuItsandthefinalfellow-up

7、resuIts.Majorcomplicationsoccurredin24cases,includingcement1eakagein13casesandvertebralheightlossin11cases,withoutcomplicatednerveimpairment，screwlooseningandscrewfractures.ConclusionExtcrnalfixationinstrumentsaresafe,effectiveandminimallyinvasiveintreatmentofthoracolumbarfractures.Ke

8、yword