后路经椎间隙截骨矫形治疗胸腰椎陈旧性骨折并后凸畸形  

Treatment of posttraumatic thoracolumbar delayed fractures and kyphosis with intervertebral osteotomy via posterior approach

作　　者：马亮[1] 许永涛[1] 佘远举[1] 

机构地区：[1]荆州市中心医院骨3科,湖北荆州434020

出　　处：《临床骨科杂志》2016年第1期11-14,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨后路经椎间隙截骨矫形治疗胸腰椎陈旧性骨折并后凸畸形的疗效。方法对27例胸腰椎陈旧性骨折并后凸畸形患者经椎间隙截骨矫形椎弓根螺钉固定治疗。结果 27例均获得随访,时间12~25个月。Cobb角：术前21°~49°（39.5°±5.5°）,术后3°~8°（4.5°±1.3°）,差异有统计学意义（P〈0.05）。无假关节形成、内固定松动断裂、矫形丢失等并发症。术后神经功能情况：1例B级恢复到C级;2例C级恢复到D级;14例D级中7例恢复到E级,7例无恢复;10例E级仍为E级。结论后路经椎间隙截骨矫形治疗胸腰椎陈旧性骨折并后凸畸形方法较为简便,并发症少,效果可靠。Objective To investigate the curative effect of treatment of posttraumatic thoracolumbar delayed fractures and kyphosis with intervertebral osteotomy via posterior approach. Methods 27 cases of posttraumatic thoracolumbar delayed fractures and kyphosis were treated by intervertebral osteotomy and bone grafting combined with pedicle screw internal fixation. Results All patients were followed up for 12 ~ 25 months. The kyphosis Cobb angles were 21° ~49°（ 39. 5° ± 5. 5°） before operation and 3° ~ 8°（ 4. 5° ± 1. 3°） after operation. The difference was statistically significant（ P〈0. 05）. There were no pseudarthrosis,internal fixation system loosening,and other complications. The neurological function was recovered obviously than preoperative. 1 case of grade B recovered to grade C,2 cases of grade C recovered to grade D,7 cases of grade D recovered to grade E and other 7 cases of grade D had no recovery,10 cases of grade E remained grade E. Conclusions Intervertebral osteotomy and bone grafting combined with pedicle screw internal fixation in the treatment of posttraumatic thoracolumbar delayed fractures and kyphosis has reliable effect and less complications,therefore it should be considered as an option for the treatment of this injury.

关 键 词：胸腰椎陈旧性骨折 后凸畸形 椎间隙截骨 内固定 

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