伤椎置钉治疗胸腰椎爆裂骨折临床探究

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1、伤椎置钉治疗胸腰椎爆裂骨折临床探究［摘要］目的探讨经伤椎置钉治疗胸腰椎爆裂骨折及维持后凸畸形矫形的有效性。方法2000年6月~2007年6月共68例，所有患者随机分为4组，每组17人。组仁单纯长节段固定；组2:长节段内固定+伤椎置钉；组3:单纯短节段固定；组4:单纯短节段+伤椎置钉。对所有患者术前、术后、随访期间的临床与放射性参数进行评估。结果平均随访47个月，未出现内固定松动或断裂现象。各组间年龄、骨折节段、随访时间以及载荷评分各指标无显著性差异(p>0.05),各组间手术时间、住院时间及失血量没有显

2、著性差异(P>0.05),各组间术前后凸角接近(P>0.05b术中后凸角矫正度数第4组最低，随访发现后凸角矫正维持效果以第仁2、4组较好。各组间术前椎体前缘平均高度百分比接近(P>0.05)，第3组术后稚体前缘高度最高，第仁2、4组术后椎体前缘高度降低。结论同时经伤椎置钉椎弓根螺钉系统固定治疗胸腰椎骨折是一种行之有效的方法。伤椎置钉可获得并维持更好的后凸畸形矫正，其在短节段实用性更强。［关键词］伤椎置钉；胸腰椎；爆裂骨折［中图分类号］R683.2［文献标识码］B［文章编号］1673—9701(2012)

3、26—0053—03ThetreatmentofthoracolumbarburstfracturesbytheuseofscrewsattheinjurylevelGUANJunhuiRANBoZHENGWenbiaoCHENFanghuLIAOFeiDepartmentofOrthopedics,TaizhouMunicipalHospitalinZhejiangProvnince,Taizhou318000,China[Abstract]ObjectiveToevaluatetheefficacy

4、offracturelevelscrewinthetreatmentofthoracolumbarburstfracturesandmaintainingthekyphosiscorrection.MethodsAllof68patientswerecollectedfromJune2000toJune2007.Theywererandomizeddividedinto4groupswithequalnumberof17patients・Ingroup1,patientsweretreatedbysim

5、plelongsegmentalposteriorinstrumentation;Ingroup2theyweretreatedasingroup1withfracturelevelscrewincorporation.Ingroup3,Patientsweretreatedbyshort—segmentposteriorinstrumentation;lngroup4,theyweretreatedasingroup3withfracturelevelscrewincorporation.Clinic

6、alandradiologicparameterswereevaluatedbeforesurgery,aftersurgery,andatfollow—up.ResultsTheaveragefollow一upwas47monthsandtheinternalfixationdidnotbecomeflexibleandcracked.Thepreoperativekyphosisangledegreeapproximatedeachotheramonggroups(P>0.05).Thekyphos

7、isanglecorrectiondegreewasthelowestinthethirdgroupintheoperation(P=0.036).Theaverageanteriorvertebralheightcompressionapproximatedeachotheramonggroupsbeforetheoperation(P>0.05).Theanteriorvertebralheightcompressionwasthehighestinthethirdgroupaftertheoper

8、ation(P>0.05).ConclusionUsingofscrewatthefracturelevelisaeffectivewayintreatmentofthoracolumbarfracture.Usingofscrewatthefracturelevelcanacquireandmaintainbe社erkyphosisdeformitycorrect!on.Thepracticalapplicabilityisbetteri