Extended posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture: improvement in orthopedic reduction efficiency

doi:10.3969/j.issn.2095-4344.2016.22.007

Abstract

Abstract:

BACKGROUND: The type of simply youth compressibility fracture of thoracic and lumbar spine with posterior vertebral injury nailing reset scheme can effectively reset with mechanics from the rear, but due to bone characteristics of the youth, the rear force cannot effectively open anterior and middle columns. To improve the effect of rear reset during the operation becomes the focus of clinical attention and difficult issues.

OBJECTIVE: To retrospectively analyze reset reconstruction effects of posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture.

METHODS: Patients with youth thoracolumbar simple flexion compression fracture were treated with posterior screw rod fixation from June 2014 to June 2015. Perioperative indicators (operation time, blood loss, average length of stay and complication rate) were recorded. Patients were followed up. Imaging indexes (anterior height of vertebral compression, Cobb angle of the injured vertebra) and subjective effect index (low back pain visual analog scale and the Oswestry Disability Index) were observed.

RESULTS AND CONCLUSION: (1) Imaging index: Anterior height of vertebral compression and Cobb angle of the injured vertebra were significantly improved after treatment (P < 0.05). No significant difference was detected at different time points after treatment (P > 0.05). (2) Subjective effect index: low back pain visual analog scale and the Oswestry Disability Index were significantly improved after treatment (P < 0.05). No significant difference was found at different time points after treatment (P > 0.05). (3) No nerve injury complications appeared in all patients, without leakage of cerebrospinal fluid. (4) Results indicated that extended posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture can obtain effective reduction due to special bone characteristics of the youth, improve reduction efficiency, do not increase patient’s trauma and the effects are affirmative.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Thoracic Vertebrae, Lumbar Vertebrae, Fractures, Bone, Internal Fixators, Tissue Engineering

CLC Number:

R318

Zou Shou-ping, Tan Xiao-yun, Huang Qiang, Lu Dao-yun. Extended posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture: improvement in orthopedic reduction efficiency[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(22): 3242-3248.

Figures/Tables 1

2.1 参与者数量分析按意向性处理，纳入青年型胸腰椎单纯屈曲压缩性骨折患者15例，全部进入结果分析，均完成至少半年以上随访，无病例脱落。 2.2 病例随访情况入选的15例患者出院前做好相关随访教育工作，对患者进行治疗前影像学评估以及治疗后1周、1个月、3个月、6个月影像学数据采集及评估工作，并且记录患者的各种主观功能数据。15例患者均顺利完成至少半年的随访。 2.3 围手术期资料 15例患者均顺利完成手术，手术时间90-150 min，平均115 min；出血量为70-150 mL，平均93 mL；住院时间为7-11 d，平均8.5 d。 2.4 影像学随访指标所有患者治疗前、治疗后及随访期间进行脊柱损伤节段X射线、CT检查，主要测量矢状位上的伤椎高度压缩度及伤椎上下终板形成的脊柱胸腰椎后凸Cobb角。具体结果详见表1，可见治疗后及随访期均有效矫形并长期保持，治疗后和治疗前相比，差异有显著性意义(P < 0.05)；治疗后不同时间点之间相比，差异无显著性意义(P > 0.05)。 2.5 主观功能量表随访指标治疗前及治疗后不同时间点对患者进行量表测量，主要记录腰背痛目测类比评分及ODI。具体结果详见表2，可见治疗后及随访期间与治疗前相比具有良好的缓解效果，并能长期保持。治疗后和治疗前相比，差异有显著性意义(P < 0.05)；治疗后不同时间点之间相比，差异无显著性意义(P > 0.05)。 2.6 并发症及不良事件患者均顺利完成手术，切口一期愈合，未出现伤口感染、肺部感染、泌尿系统感染等并发症。所有患者均未发生神经损伤并发症，无手术操作脑脊液漏现象。 2.7 典型病例男性患者，21岁，高处坠落致T12椎体压缩性骨折，采用延伸后路钉棒置入内固定方案治疗(固定T10-L1节段)，术后矫形满意，见图1。随访1年，无不良反应。"

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