椎弓根钉-棒结合椎体支柱块治疗胸腰椎骨折  

Study on Clinical Effect of the Treatment of Thoracolumber Fracture Using Transpedicular Screwrod with Vertebral Spacer

作　　者：丁健[1] 唐亮[1] 房宏生 洪克建 

机构地区：[1]江苏省如皋市人民医院骨科,江苏如皋226500

出　　处：《实用骨科杂志》2011年第9期773-776,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨椎弓根钉-棒系统结合椎体支柱块治疗胸腰椎骨折的临床疗效。方法自2008年3月至2010年6月采用椎弓根钉-棒系统内固定结合椎体支柱块治疗胸腰段骨折81例,所有患者术后及随访时均行X线正侧位摄片及CT检查,术前测量与伤椎相邻的上、下椎体中央高度,取其平均值H正常作为伤椎压缩前高度的估计值。测量术前伤椎高度记为H′。测量术后伤椎椎体中央高度H,分别记为H术后、H随访。将H术后、H随访与H′相比,并做两者的配对t检验。将H术后、H正常及H随访两两相比,作配对t检验。测量术前、术后以及随访时脊柱的Cobb角,分别记为Cobb术前、Cobb术后、Cobb随访。将Cobb随访、Cobb术后分别与Cobb术前作配对t检验,将Cobb随访与Cobb术后作配对t检验。结果 73例获得随访,随访时间6～25个月,平均13个月。椎体支柱块能有效的恢复椎体中柱的高度,重建前、中柱的稳定性。H术后、H正常及H随访两两相比,P>0.05,差别无统计学意义。H术后、H随访与H′相比,两者P<0.05,差别有统计学意义。Cobb随访、Cobb术后分别与Cobb术前相比,P<0.05,差别有统计学意义。Cobb随访与Cobb术后相比,P>0.05,差别无统计学意义。结论椎弓根钉-棒系统内固定结合椎体支柱块能有效的恢复并维持伤椎高度,促进椎体内骨折愈合,重建椎体前中柱的稳定性,防止远期椎体塌陷。Objective To explore clinical effect of the treatment of thoracolumber fracture using transpedicular screw-rod with vertebral spacer.Methods 81 cases who suffered thoracolumber fracture were treated with transpedicular screw-rod with vertebral spacer during March 2008 to June 2010.All the cases were treated using Xray and CT.The assessment height of injured vertebras before crashed was averaged of the two middle height of vertebras which up and down the injured vertebras,signed H（normal） preoperative.H’signed as the height of injured vertebras. The middle height of injured vertebras were measured,signed H（after surgery）.H（followed up） postoperative. The Cobb angle was measured preoperative,postoperative and followed-up,which signed as Cobb（preoperative）、Cobb（postoperative） and Cobb（followed-up）.Results The results were analyzed by paired t test.Results 73 cases were followed up during 6～25 months,averaged 13 months.There was no significant difference during H（after surgery）,H（normal） and H（followed up）,（P〉0.05）.There was significant different between H（after surgery）,H （followed up） and H’（P〈0.05） respectively.Significant difference showed between Cobb（followed-up）.Cobb（post-operative） and Cobb（preoperative） respectively（P〈0.05）.No significant difference showed between Cobb（followed-up） and Cobb（postoperative）（P〈0.05）.Conclusion The method of using transpedicular screw-rod with vertebral spacer can effectively recover the height of injured vertebras and reconstruct the stability of the anterior and posterior column so that to prevent collapse

关 键 词：脊柱骨折 椎体支柱块 椎弓根钉-棒系统 

分 类 号：R683.2[医药卫生—骨科学]