后路椎板减压螺钉置入修复胸腰椎骨折合并脊髓受压:Cobb’s角及伤椎高度随访  

Posterior laminectomy for thoracolumbar fracture and spinal cord compression:a follow-up on Cobb's angle and vertebral height

作　　者：李军 王永胜 封挺 王波 邱健钊 

机构地区：[1]广州市番禺区中心医院创伤烧伤科,广东省广州市511400

出　　处：《中国组织工程研究》2016年第22期3249-3254,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:胸腰椎由于特殊的生理解剖位置,骨折发生时脊柱的稳定性状态十分复杂,要确定脊柱稳定性具有一定的难度,应该根据其个体化情况,探寻更加有效的内固定修复方法。目的:随访后路椎板减压螺钉置入内固定修复胸腰椎骨折合并脊髓受压患者的Cobb’s角及伤椎高度变化,并与前路椎板减压内固定进行对比。方法:纳入广州市番禺区中心医院2013年1月至2014年11月确诊为胸腰椎骨折合并脊髓受压的患者100例,随机分为后路椎板减压内固定组和前路椎板减压内固定组,每组50例。对2组患者治疗前、治疗后1个月的美国脊髓损伤学会(ASIA)触觉评分、运动评分、Cobb’s角及伤椎高度进行评估,比较2组患者的内固定修复效果。结果与结论:12组患者治疗前的各项指标差异无显著性意义(P>0.05);2治疗1个月后,后路椎板减压内固定组患者触觉、运动评分、Cobb’s角及伤椎高度等各项指标均优于前路椎板减压内固定组,2组比较差异有显著性意义(P<0.05);3结果提示,与前路椎板减压螺钉置入内固定相比,后路椎板减压螺钉置入内固定修复胸腰椎骨折合并脊髓受压的效果更优,可明显解除患者的脊髓压迫情况,是胸腰椎骨折合并脊髓受压安全有效的修复方法。BACKGROUND：Due to special physiological and anatomical location,stability of the spine is very complicated during thoracolumbar fractures.It is difficult to identify the stability of the spine.It should be based on their individual circumstances,to explore more effective internal fixation repair method.OBJECTIVE：To explore the Cobb＇s angle and vertebral height of patients with thoracolumbar fracture and spinal cord compression treated with posterior laminectomy and screw fixation,and compared with anterior laminectomy.METHODS：One hundred patients with thoracolumbar fracture and spinal cord compression,who were treated in the Panyu District Central Hospital from January 2013 to November 2014,were enrolled in this study.The patients were equally and randomly divided into posterior laminectomy fixation group and anterior laminectomy fixation group.Tactile and sports of American Spinal Injury Association scores,Cobb＇s angle and vertebral height were assessed before treatment and 1 month after treatment,and fixation effects were compared between the two groups.RESULTS AND CONCLUSION：（1） No significant difference in each index was detected between the two groups preoperatively（P〉0.05）.（2） Tactile and sports of American Spinal Injury Association scores,Cobb＇s angle and vertebral height were better in the posterior laminectomy fixation group than in the anterior laminectomy fixation group at 1 month postoperatively（P〈0.05）.（3） These findings indicated that compared with the anterior laminectomy fixation,posterior laminectomy fixation for thoracolumbar fracture combined with spinal cord compression obtained better outcomes,and could obviously relieve spinal cord compression.Posterior laminectomy fixation is a safe and effective treatment method for thoracolumbar fracture and spinal cord compression.

关 键 词：胸椎 腰椎 骨折 内固定器 组织工程 骨科植入物 脊柱植入物 胸腰椎骨折合并脊髓受压 后路椎板减压内固定 前路椎板减压内固定 触觉评分 运动评分 

分 类 号：R318[医药卫生—生物医学工程]