后路有限截骨矫形治疗陈旧性胸腰椎骨折  

Posterior limited osteotomy for the treatment of old thoracolumbar fracture

作　　者：姚树强[1] 姜泽威 于建林[1] 杨永军[1] 周纪平[1] 

机构地区：[1]山东省文登整骨医院脊柱脊髓一科,山东威海264300

出　　处：《颈腰痛杂志》2015年第4期301-303,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的评价有限截骨矫形并椎间植骨治疗胸腰椎陈旧性骨折的临床效果。方法分析2008-07-2013-12采用有限截骨,椎弓根钉固定,椎间植骨融合治疗陈旧性胸腰椎骨折患者62例。采用视觉模拟评分(Visual Analogue Scale,VAS)及日本骨科协会(Japanese Orthopadeics Association,JOA)评分(29分法)评价临床症状的改善情况,测量X线侧位片Cobb角,评价后凸畸形的纠正和植骨融合情况。结果所有患者均获随访。后凸Cobb角术前平均为40.1°,术后8.4°;VAS评分术前平均7.2分,术后2.9分;JOA评分术前平均为13.4分,术后24.1分。术前术后比较差异均有统计学意义(P<0.05)。无血管神经损伤等严重并发症发生,术后半年植骨牢固愈合。无内固定松动、断裂等相关并发症。结论有限截骨矫形可获得满意的减压及矫形效果,重建脊柱序列和稳定性,是陈旧性胸腰椎骨折后凸畸形较理想的治疗方法。Objective To evaluate the clinical effects of limited osteotomy in the treatment of old fracture of thoracohmbar. Methods From July 2008 to December 2013,the finite osteotomy,pedicle screw fixation,intervertebral bone graft fusion were used for the treatment of old thoracolumbar fractures in 62 patients. The improvement of the clinical symptoms was evaluated by visual analog scale（VAS） and the Japanese Orthopaedic Association（JOA） score（29 points system）. Cobb angle X-ray photography was measured to evaluate kyphosis correction and bone fusion. Results All patients were followed up. The average Cobb＇s angle was 40.1° pre-operatively,and 8.4° post-operativly. The average VAS score was 7.2 points pre-operatively,2.9 points post-operatively. The mean JOA score before operation was 13.4 points, 24.1 points post-operatively. There Were statistical significant differences in the above indexes between pre-operation and post-operation（P〈0.05）. No postoperative complications such as artery injury,exacerbation of neurological symptoms were observed. Bony fusion was observed after 6 months of operation,no failure of internal fixation and losing of reduction occurred. Conclusion Limited osteotomy can obtain satisfactory correction effect of decompression and reconstruction of spinal stability, and the sequence,it is the ideal treatment for old thoracolumbar fractures.

关 键 词：胸腰椎骨折 后凸畸形 截骨 内固定 

分 类 号：R683.2[医药卫生—骨科学]