中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3185-3188.doi: 10.3969/j.issn.1673-8225.2010.17.037

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

无神经症状单节段胸腰椎爆裂型骨折行后路短节段椎弓根螺钉内固定置入186例

王骏骅，杨惠林，耿德春，陈  亮，包肇华，梅  盺   

  1. 苏州大学附属第一医院骨科，江苏省苏州市 215006
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 作者简介:王骏骅☆，男，1978年生，江苏省盐城市人，汉族，苏州大学在读博士，主治医师，主要从事脊柱外科的研究。 wangjunhua@suda.edu.cn

Posterior short-segmental pedicle screw fixation in treatment of 186 patients with single-level thoracolumbar burst fracture without nerologic deficit

Wang Jun-hua, Yang Hui-lin, Geng De-chun, Chen Liang, Bao Zhao-hua, Mei Xin   

  1. Department of Orthopedics, First Hospital of Soochow University, Suzhou   215006, Jiangsu Province, China
  • Online:2010-04-23 Published:2010-04-23
  • About author:Wang Jun-hua☆, Studying for doctorate, Attending physician, Department of Orthopedics, First Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China wangjunhua@suda.edu.cn

PDF

431

被引次数

14

摘要：

背景：胸腰椎骨折治疗方法众多，但是对于无神经症状的爆裂型骨折，采用简单的手术方法治疗，是否在减少创伤的同时能够取得较好的疗效，从而避免手术的扩大化尚不清楚。
目的：观察采用单纯后路短节段椎弓根螺钉系统置入治疗无神经症状的单节段胸腰椎爆裂型骨折的疗效。
方法：选择2003-09/2008-01苏州大学附属第一医院骨科收治的无神经症状单节段胸腰椎爆裂型骨折患者186例，男152例，女34例，年龄18~65岁。均采用单纯后路短节段椎弓根螺钉内固定置入治疗，椎管内骨块占位采用间接复位。于置入前、置入后及置入后1年余取内固定前摄以伤椎为中心的X射线正侧位片和CT，对X射线平片和CT进行测量，统计伤椎前缘高度、伤椎横截面积内骨块的占有率。
结果与结论：伤椎前缘置入前高度平均为正常的42%，术后为98%，内固定取出术前伤椎前缘高度为正常高度的98%。伤椎横截面积内骨块占有率，术前平均为34%，术后平均为13%，内固定取出术前为8%。提示应用后路短节段椎弓根螺钉系统治疗无神经症状的胸腰椎爆裂型骨折，能够提供脊柱足够的稳定性，有效恢复椎体高度、生理弧度和椎管容积。

关键词: 胸腰椎, 骨折, 椎弓根, 内固定, 置入, 硬组织植入物

Abstract:

BACKGROUND: There are many methods to treat thoracolumbar fractures. However, it remains unclear whether a simple operation to treat a thoracolumbar burst fracture can decrease the trauma and obtain better effect to avoid the enlargement of operation.
OBJECTIVE: To investigate the clinical outcome of posterior short-segmental transpedicular screw system internal fixation in treatment of single-level thoracolumbar burst fracture without nerologic deficit.
METHODS: A total of 186 patients with single-level thoracolumbar burst fracture but without nerologic deficit treated in the First Affiliated Hospital of Soochow University between September 2003 and January 2008, including 152 males and 34 females, aged 18 to 65 years, were treated by posterior pedicle screw. The intraspinal bone fragments were treated with indirect decompression. All patients were checked with radiography and CT scan before/after operation as well as before implant removal. The correction of anterior vertebral body height and the ratio of bone fragment to cross section area of spinal canal were measured.
RESULT AND CONCLUSION: Compared with normal, the anterior vertebral body height was 42% before operation, 98%after operation, and 98% before implant removal. The ratio of bone fragment to cross section area of spinal canal was 34% before operation, 13% after operation, and 8% before implant removal. Internal posterior short-segmental transpedicular screw fixation treating single-level thoracolumbar burst fracture without nerologic deficit can obtain stability of spinal column, and it is beneficial to recovery of body height, physiologic postural contour and canal volumn.

中图分类号: