后路减压联合钉棒内固定系统对重度胸腰椎骨折脱位并神经损伤的疗效分析  

The effect of posterior decompression and pedicle screw rod internal fixation system on severe thoracolumbar fracture combined with nerve injury

作　　者：肖建林[1] 卢吉平[1] 廖前德[1] 胡昌希[1] 徐高斌 牛永刚[1] 

机构地区：[1]中国人民解放军第163医院骨三科

出　　处：《临床外科杂志》2015年第12期937-939,共3页Journal of Clinical Surgery

摘　　要：目的分析后路减压联合钉棒内固定系统治疗重度胸腰椎骨折脱位并神经损伤的临床疗效。方法重度胸腰椎骨折脱位并神经损伤患者37例，均在全身麻醉下接受后路减压联合钉棒固定骨折椎体复位术。采用Frankel分级评估手术前后及随访期间神经功能恢复情况；采用疼痛视觉模拟评分（VAS）评估手术前后背部疼痛程度；测量手术前后骨折椎体的前高比与后高比的变化以评估骨折椎体复位情况及植骨融合情况。结果患者术后随访时间为（23．8±8．3）个月。与术前相比，在末次随访时Frankel分级在D级以下患者症状改善率为80．65％，E级比例为35．14％。与术前相比，末次随访VAS较低，而骨折椎体的前高比与后高比均较高，差异有统计学意义（P〈0．05）。结论后路减压联合钉棒固定骨折椎体复位是治疗重度胸腰椎骨折脱位并神经损伤的理想手术方式。Objective To analyze the effect of posterior decompression and pedicle screw rod internal fixation system on severe thoracolumbar fracture combined with nerve injury. Methods A total of 37 patients with severe thoracolumbar fracture combined with nerve injury were collected to retrospective analysis. All patients were received the therapy of the posterior decompression and pedicle screw rod inter- nal fixation system under total anesthesia. The functional recovery degrees of spinal cord were evaluated by Frankel classification at the pre-operation and follow-up period. The degrees of back pain were evaluated by VAS score at the pre-operation and follow-up period. The average anterior and posterior vertebral height were measured and compared to evaluate correction of fracture. Results All patients were followed up （ 23.8 ＋_ 8.3 ） months after post-operation. Compared to pre-operation, the ratio of symptom improvement in under grade D patients at last follow-up was 80.65% and the rate of grade E was 35.14%. Compared to pre-operation,the VAS score at last follow-up was obviously lower, but the anterior vertebral height and posterior vertebral height at last follow-up were obviously higher（P 〈 0.05）. Conclusions The combina- tion of posterior decompression and pedicle screw rod internal fixation system is an ideal surgical treatment for the severe thoracolumbar fracture combined with nerve injury.

关 键 词：胸腰椎骨折脱位并神经损伤 钉棒内固定系统 后路减压 骨折椎体复位 

分 类 号：R687.3[医药卫生—骨科学]