旋转棒技术结合短节段固定治疗亚急性期胸腰段椎体压缩骨折  

Posterior rotating rod reduction combined with short-segment fixation in management of subacute thoracolumbar compression fractures

作　　者：马田成[1] 王林[1] 李天清[1] 冯亚非[1] 马翔宇[1] 马真胜[1] 桑宏勋[1] 雷伟[1] 

机构地区：[1]第四军医大学西京骨科医院脊柱二科,西安710032

出　　处：《中华创伤骨科杂志》2015年第6期509-512,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨旋转棒技术结合短节段固定治疗亚急性期胸腰段椎体压缩骨折的效果.方法 对2011年6月至2013年2月收治的24例亚急性期（≥5 d）胸腰段（T11至L2）椎体压缩骨折患者资料进行回顾性分析,男15例,女9例;年龄21 ～44岁,平均33.5岁;骨折部位：T112例,T125例,L111例,L26例.均采用旋转棒技术结合短节段固定治疗,观察并比较术前、术后和术后12个月时椎体前缘高度压缩率及局部后凸cobb角变化,以及术前与术后12个月时Oswestry功能障碍指数（ODI）、SF-36生活质量调查表及视觉模拟评分（VAS）变化. 结果 所有患者术后随访12～26个月（平均13.8个月）.所有患者术后和术后12个月的伤椎椎体前缘高度压缩率、cobb角、VAS评分分别与术前比较差异均有统计学意义（P＜0.05）;而术后12个月的伤椎椎体前缘高度压缩率、cobb角、VAS评分与术后比较,差异均无统计学意义（P＞0.05）.术后12个月的ODI、SF-36生活质量调查表中总体健康、活力、精神健康、躯体疼痛、生理功能与术前比较,差异均有统计学意义（P＜0.05）.SF-36生活质量调查表中社会功能、生理职能、情感职能评分与术前比较,差异均无统计学意义（P＞0.05）. 结论 旋转棒技术结合短节段固定治疗亚急性期胸腰段椎体压缩骨折临床效果满意.Objective To evaluate the efficacy of rotating rod reduction combined with short-segment fixation for subacute thoracolumbar compression fractures.Methods From June 2011 to February 2013,24 patients with subacute （≥5 days） thoracolumbar fracture （T11-L2） were treated at our department.They were 15 males and 9 females,aged from 21 to 44 years （average,33.5 years）.The fracture occurred at T1 1 in 2 cases,at T12 in 5,at L1 in 11 and at L2 in 6.They were all treated by rotating rod reduction combined with short-segment fixation.The efficacy was evaluated by comparing vertebral compression rates,cobb angles,Oswestry disability index （ODI） scores,short form 36 questionnaire （SF-36） scores and visual analogue scale （VAS） scores at preoperation,immediate postoperation and 12 months postoperation.Results The patients were followed up for 12 to 26 months （average,13.8 months）.Their postoperative vertebral compression rates,cobb angles and VAS scores were significantly improved compared with the preoperative ones （P 〈 0.05）,but there were no significant differences regarding vertebral compression rates,cobb angles or VAS scores between immediate postoperation and 12 months postoperation （P 〉 0.05）.The ODI scores and the general health perceptions,vitality,mental health,bodily pain and physical functioning in SF-36 at 12 months postoperation were significantly improved compared with preoperation （P 〈 0.05）,but there were no significant differences regarding social functioning,physical role functioning or emotional role functioning between preoperation and postoperation （P 〉 0.05）.Conclusion Rotating rod reduction combined with short-segment fixation can achieve satisfactory clinical effects in treatment of subacute thoracolumbar compression fractures.

关 键 词：胸椎 腰椎 骨折 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]