椎弓根螺钉置入内固定系统治疗胸腰段骨折脱位疗效观察  

Clinical Efficacy and Biomechanics of Pedicle Screw Implantation Internal Fixation System for Thoracolumbar Fracture Dislocation Patients

作　　者：杨贤玉 张长江 李来好 李洪珂 潘登 王鹏程 

机构地区：[1]平煤神马集团总医院脊柱骨病科,河南平顶山467000

出　　处：《医学临床研究》2015年第7期1280-1283,共4页Journal of Clinical Research

摘　　要：【目的】探讨椎弓根螺钉置入内固定系统治疗胸腰段骨折脱位的临床疗效。【方法】收集胸腰椎段骨折脱位患者120例，均采用椎弓根置入内固定系统治疗，观察手术前、手术后3d、手术后1年患者脊髓神经损伤程度、骨折复位、疼痛程度、腰背残障功能。【结果】术后3d、术后1年脊髓神经损伤B级所占比例显著低于手术前，C～E级所占比例均显著高于手术前（P〈0．05），但术后3d与术后1年Frankel分级比较差异无统计学意义（P〉0．05）。术后3d、术后1年患者Cobb角显著低于手术前，椎体恢复度、椎体前缘高度显著高于手术前（P〈0．05）；手术前后各时段椎体后缘高度比较差异无统计学意义（P〉0．05）。术后3d、术后1年患者视觉模拟评分（Visual Analogue Seale，VAS）、功能障碍指数（Oswestry Disability Index，ODD评分均显著低于手术前（P〈0．05），其中术后1年患者VAS、ODI评分亦显著低于术后3d（P〈0．05）。【结论】椎弓根内固定系统能够显著改善胸腰段骨折脱位患者的脊髓神经功能，促进骨折复位，值得临床推广。[Objective] To explore the clinical efficacy and biomeehanics of pedicle screw implantation internal fixation system for thoracolumbar fracture dislocation patients. [Methods] A total of 120 patients of thoraco]umbar fracture dislocation from April 2009 to April 2014 were treated with pedicle screw implantation internal fixation system. The degree of spinal cord injury, pain level, disability status and fracture reduction were evaluated before and after 3 days and 1 year after operation. [Results] After 3 days, 1-year class B pro-portion was significantly lower than that of before operation. The proportions of classes C-E were significantly higher than those pre-operation （ P 〈0.05）. As compared with 3 days, 1-year Frankel grade proportion had no statistical significance （ P 〉0. 05）. After 3 days, 1-year Cobb angle was significantly lower than that be-ore operation, restorations of vertebral body and height were significantly higher than those before operation （ P 〈0.05）. Before and after operation, posterior margin of vertebral body height had no statistical difference （ P 〉0.05）. After 3 days, after 1 year in patients with visual analogue scale （VAS） and Oswestry disability index （ODD scores were significantly lower than those before operation. After 1 year, patients with VAS and ODI scores were also significantly lower than those at Day 3 post-operation. Alt differences had statistical differences （ P 〈0.05）. [Conclusion] Pedicle screw internal fixation system can significantly improve spinal nerve function and promote fracture reduction in thoracolumbar fracture dislocation patients.

关 键 词：骨螺丝 骨折固定术 内/方法 脊柱骨折/外科学 腰椎 胸椎 生物力学 

分 类 号：R683.2[医药卫生—骨科学]