中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (22): 3242-3248.doi: 10.3969/j.issn.2095-4344.2016.22.007

• 脊柱植入物 spinal implant • 上一篇    下一篇

延伸后路钉棒内固定修复青年型胸腰椎单纯屈曲压缩性骨折:改善矫形复位效率

邹守平,谭小云,黄 强,卢道云   

  1. 解放军第413医院骨科,浙江省舟山市 316000
  • 修回日期:2016-04-18 出版日期:2016-05-27 发布日期:2016-05-27
  • 通讯作者: 谭小云,博士,主任医师,解放军第413医院骨科,浙江省舟山市 316000
  • 作者简介:邹守平,男,1973年生,江西省丰城市人,汉族,1996年江西医学院毕业,副主任医师,主要从事脊柱外科方面的研究。
  • 基金资助:

    总后全军医学科研项目(CWS11J261)

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

Zou Shou-ping, Tan Xiao-yun, Huang Qiang, Lu Dao-yun   

  1. Department of Orthopedics, 413 Hospital of Chinese PLA, Zhoushan 316000, Zhejiang Province, China
  • Revised:2016-04-18 Online:2016-05-27 Published:2016-05-27
  • Contact: Tan Xiao-yun, M.D., Chief physician, Department of Orthopedics, 413 Hospital of Chinese PLA, Zhoushan 316000, Zhejiang Province, China
  • About author:Zou Shou-ping, Associate chief physician, Department of Orthopedics, 413 Hospital of Chinese PLA, Zhoushan 316000, Zhejiang Province, China
  • Supported by:

    the PLA General Logistics Medical Scientific Research, No. CWS11J261

摘要:

文章快速阅读:

 

 

 
文题释义:
经伤椎后路钉棒内固定:经伤椎固定的后路矫形椎弓根螺钉内固定技术应用于胸腰椎骨折由于其良好的生物力学效应和损伤控制,在临床上逐渐获得推崇和开展。伤椎固定技术缩短了传统长节段固定矫形的固定节段长度,并有效的提高了在矫形复位过程中脊柱的撑开应力,促进脊柱压缩节段的结构复位和重建。
延伸后路钉棒内固定:解放军第413医院骨科在临床应用中开展了延伸后路钉棒内固定技术,在前期的伤椎固定技术基础上,根据人体脊柱胸腰椎骨折发生压缩性骨折的生物力学成因,对经伤椎固定的6钉技术向上延伸固定一个节段,提高轴向复位过程中的生物力学撑开效果。主要目的是针对青年型脊柱胸腰椎压缩性骨折复位效果不满意,试图通过技术的改进提高临床矫形效率。
 
摘要
背景:青年型胸腰椎单纯屈曲压缩性骨折采用后路伤椎置钉复位方案能够从后方进行力学作用承载从而有效复位,但是由于青年人的骨质特点,后方作用力不能有效撑开前、中柱,提高修复手术时后方复位效果成为临床关注的重点和难点问题。
目的:回顾性分析采用延伸后路钉棒置入内固定修复青年型胸腰椎单纯屈曲压缩性骨折的复位重建效果。
方法:对2014年6月至2015年6月收治的青年型胸腰椎单纯屈曲压缩性骨折患者采用延伸后路钉棒系统置入内固定方案治疗,记录患者的围手术期指标(手术时间、出血量、平均住院日及并发症发生率),并对患者进行术后随访,主要观察患者影像学指标(伤椎前缘高度压缩度、伤椎后凸Cobb角)及主观功能指标(腰背痛目测类比评分及Oswestry功能障碍指数)。

结果与结论:①影像学指标:治疗后患者伤椎前缘高度压缩度、伤椎后凸Cobb角与治疗前相比均显著改善(P < 0.05);治疗后不同时间点相比差异无显著性意义(P > 0.05);②主观功能指标:治疗后患者腰背痛目测类比评分及Oswestry功能障碍指数与治疗前相比均显著改善(P < 0.05);治疗后不同时间点相比差异无显著性意义(P > 0.05);③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。④结果提示,采用延伸后路钉棒置入内固定修复青年型胸腰椎单纯屈曲压缩性骨折,可以针对青年型特殊的骨质条件进行有效的矫形复位,改善复位效率,且并不增加患者创伤,效果肯定。

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
ORCID: 0000-0002-7207-0759(谭小云)

关键词: 骨科植入物, 脊柱植入物, 胸腰椎骨折, 青年患者, 后路矫形手术, 脊柱内固定, 围手术期, 临床疗效

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

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