非相邻多节段脊柱骨折诊治分析  

Diagnosis and treatment of multiple-level noncontiguous spinal fractures

作　　者：王刚祥[1] 周海东[1] 赵阳虎 王志刚[1] 周亮[1] 徐宏宇[1] 宋南炎 迟英俊[1] 

机构地区：[1]嵊州市人民医院骨科,浙江嵊州312400

出　　处：《临床骨科杂志》2015年第6期655-657,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨非相邻多节段脊柱骨折手术方式和疗效。方法 21例非相邻多节段脊柱骨折患者通过X线、CT和MRI检查确诊,接受前路减压植骨内固定和（或）后路椎弓根钉固定治疗。比较术前、末次随访的疼痛视觉模拟评分（VAS）及Cobb角。结果 21例患者均获得随访,时间12-36个月。VAS评分：术前为（7.0±1.2）分,末次随访为（2.2±0.5）分;Cobb角：术前25°±2.8°,末次随访为5°±1.5°。两项指标末次随访与术前比较差异均有统计学意义（P〈0.05）。末次随访JOA评分：优14例,良3,差4例。结论对于非相邻多节段脊柱骨折应分别根据关键损伤节段和非关键损伤节段情况,通过手术治疗以达到椎管减压、恢复正常的脊柱序列以及重建脊柱稳定性。Objective To investigate the surgical methods and outcome of multiple-level noncontiguous spinal fractures. Methods 21 patients with multiple-level noncontiguous spinal fractures diagnosed by X-ray,CT and MRI were undergone anterior decompression and bone grafting and internal fixation and / or posterior pedicle screw fixation.Pain visual analogue scale（ VAS） and Cobb angle of vertebral body with critical injury were compared between preoperation and the last follow-up. Results 21 patients were followed up for 12 - 36 months. VAS： preoperative score was 7. 0 ± 1. 2,the last follow-up 2. 2 ± 0. 5; Cobb angle： preoperative angle was 25° ± 2. 8°,the last follow-up5° ± 1. 5°. The difference was statistically significant between degrees of preoperation and the latest follow-up（ P〈0. 05）. According to JOA score,14 cases were excellent,good in 3,poor in 4. Conclusions The patients with multiple-level noncontiguous spinal fractures should undergo the surgery of decompression and restoration of normal spinal sequence and the reconstruction of spinal stability mainly according to the critical injury section and non critical injury section.

关 键 词：脊柱骨折 多节段 植骨 后路椎弓根钉固定 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]