多节段椎弓根钉置入治疗强直性脊柱炎合并胸腰椎骨折:1年随访  

Multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis: one-year follow-up

作　　者：武兴国[1] 黄健[1] 蒋煜青[1] 郭伟康[1] 王军[1] 

机构地区：[1]中山大学附属梅州医院骨四科,广东省梅州市514031

出　　处：《中国组织工程研究》2014年第9期1368-1373,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于强直性脊柱炎合并胸腰椎骨折患者,采用传统方法行短节段经椎弓根内固定或前路钉板或钉棒系统固定由于其骨质疏松明显,螺钉抗拔出力较差,治疗后容易出现内固定松动。目的:探讨多节段经椎弓根内固定治疗强直性脊柱炎合并胸腰椎骨折的效果。方法:选择2009年1月至2012年12月中山大学附属梅州医院骨科收治的强直性脊柱炎合并胸腰椎骨折患者11例,行后路复位多节段椎弓钉内固定,其中6例采用经伤椎椎弓根固定。结果与结论:11例患者均获随访,随访时间13-36个月。所有患者影像学显示均骨性愈合,未见内固定松动断裂现象。3例脊髓神经损伤按Frankel分级由C级恢复至E级。JOA评分评估腰背痛改善率为100%。结果显示经后路复位多节段椎弓根钉置入治疗强直性脊柱炎合并胸腰椎骨折,可获得坚强内固定,骨折愈合良好。BACKGROUND： Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pull-out strength in patients with thoracolumbar fracture with ankylosing spondylitis. OBJECTIVE： To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis. METHODS： Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. All the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra. RESULTS AND CONCLUSION： All of the 11 patients were followed up for 13 to 36 months. Solid bone healing was achieved in all of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of Spinal cord injury achieved Frankel＇s class Efrom class C recovery. Lumbodorsal pain rate achieved 100% according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by operation.

关 键 词：植入物 脊柱植入物 强直性脊柱炎 胸腰椎骨折 多节段经椎弓根内固定 

分 类 号：R318[医药卫生—生物医学工程]