前路椎间盘松解矫形治疗无神经症状胸腰段陈旧性骨折伴后凸畸形的疗效观察  

Anterior Disc Release Orthodontic Treatment for Thoracolumbar Old Fractures without Neurological Symptom Complicated by Kyphosis

作　　者：尚晖[1] 常巍[1] 王达义[1] 温国宏[1] 

机构地区：[1]湖北医药学院附属十堰市太和医院脊柱外科,湖北省十堰市442000

出　　处：《中国全科医学》2011年第12期1357-1359,共3页Chinese General Practice

摘　　要：目的探讨前路单纯椎间盘松解矫形治疗无神经症状的胸腰段陈旧性骨折伴后凸畸形的临床疗效。方法回顾性分析我科2007年1月—2009年6月收治的34例无神经症状的胸腰段陈旧性骨折伴后凸畸形患者的临床资料,其中男13例,女21例;年龄41～65岁,平均51岁。所有患者均行前路椎间盘松解植骨矫形钢板内固定术,手术前后均行影像学检查并测量后凸畸形Cobb角的变化,术前和术后1年均进行腰背痛VAS评分和Odem评分,术中详细记录手术时间和出血量等指标。结果患者均获得随访,随访时间12～28个月;植骨均骨性愈合,未出现神经损伤、大血管损伤、钢板螺钉松动断裂等并发症;术前胸腰段的后凸畸形Cobb角29°～45°,平均41.7°,术后胸腰段后凸畸形Cobb角10°～17°,平均13.7°,术后矫正率为67.15%;平均手术时间(153±31)m in;平均出血量(712±43)m l;腰背疼痛VAS评分由术前(7.9±2.2)分改善至(2.5±0.7)分;Odem评分优22例,良12例。结论前路单纯椎间盘松解矫形治疗无神经症状的胸腰段陈旧性骨折伴后凸畸形,具有良好的临床效果。Objective To explore the clinical effects of anterior disc release orthodontic treatment on thoracolumbar old fractures without neurological symptom complicated by kyphosis.Methods A retrospective analysis was performed on clinical data of 34 patients with thoracolumbar old fractures without neurological symptom complicated by kyphosis（13 males,21 females,aged the years of 41～65,averaging 51） admitted from January 2007 to June 2009.All patients underwent anterior disc release,bone graft and plate internal fixation.Imaging studies were performed before and after operation,and the changes of hyphosis Cobb angle measured.VAS scores and Odem scores for low back pain were carried out 1 year before and after operation,operative time and blood loss recorded during operation.Results All patients were followed up for 12~28 months.Bone grafts were synostosis without complications such as neurological damages,vascular trauma,screws loosening or broken.Kyphosis Cobb angle were 41.7°averagely before operation,10°~17°after operation,averaging 13.7°,with a postoperative correction rate of 67.15%.Mean operative time was（153±31） min,average blood loss（712±43） ml.Low back pain VAS scores improved pre-operative（7.9±2.2） to post-operative（2.5±0.7）.Twenty-two patients had excellent Odem scores,12 had good.Conclusion Simple anterior disc release orthodontic treatment for thoracolumbar old fractures without neurological symptom complicated by kyphosis is of good therapeutic effect.

关 键 词：胸腰段骨折 脊柱后凸 椎间盘松解术 前路矫形 

分 类 号：R682.3[医药卫生—骨科学]