后路复位椎弓根长短节段固定治疗严重胸腰椎骨折的临床疗效比较  

Comparison of Clinical Effect of Long Segment Pedicle Screw System Versus Short Segmen for Treatment of Serious Thoracolumbar Spine Fracture

作　　者：朱裕成[1] 郑红兵[1] 马军[1] 许兴柏[1] 王冰[1] 朱爱祥[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院脊柱外科,江苏省223800

出　　处：《中国骨与关节损伤杂志》2010年第9期775-777,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较经后路复位椎弓根长、短节段固定治疗严重胸腰椎骨折的临床疗效。方法 68例严重胸腰椎骨折患者采用短节段固定42例,长节段固定26例。随访时摄X线正侧位片,测量伤椎前缘高度及脊柱后凸角度,并评估神经功能恢复情况、腰痛程度和腰椎活动度。结果临床疗效、伤椎前缘高度及脊柱后凸角度的恢复,两组无显著性差异,但合并椎体II度以上脱位者长节段固定较短节段固定椎体复位更好,后凸角度丢失也较少;短节段固定3例发生内固定失效。结论严重胸腰椎骨折选择后路短节段或长节段固定,都能达到较满意的伤椎复位、临床疗效和畸形矫正,合并严重脱位选用长节段固定,在伤椎复位、矫正后凸畸形、减少内固定失效更有优势。Objective To compare the clinical effect of long segment pediele screw system versus short segmenton for treatment of serious thoracolumbar spine fracture.Methods Sixty-eight patients with serious thoraeolumbar spine fracture were fixed with pedicle screw system.Fourty-two patients were fixed with short segment,twenty-six patients were fixed with short segment.Injured vertebral height and spinal Cobbs angle on X-ray were measured.Neuro-function recovery,back pain,lumbar activity were evaluated.Results Post-operative injured vertebra/height and spinal Cobbs angle was statistically improved in two groups versus pre-operation. There was no statistically difference between 2 groups on clinical effect, injured vertebral height and spinal Cobbs angle.Better reduction and less lost of Cobbs angle in more than II grade vertebral dislocation were found in long segment fixation group than in short segment fixation group. Fixation failure were found in 3 cases in short segment fixation group.Conclusion Good clinical effect, satisfied vertebral reduetion and abnormity rectification could be gained in treatment of serious thoracolumbar spine fracture by either long segment or short segment fixation in serious thoracolumbar spine fracture. Long segment fixation is better choice for serious vertebral dislocation.

关 键 词：严重胸腰椎骨折 短节段固定 长节段固定 

分 类 号：R681.5[医药卫生—骨科学]