伤椎置钉短节段固定治疗A型胸腰椎骨折的疗效评价  

Clinical efficacy of short segment pedicle screws fixation via the injured thoracolumbar vertebrae for treating type A thoracolumbar fracture

作　　者：白建忠[1] 徐炜[1] 施惠峰 于荣华[1] 梁朝革[1] 

机构地区：[1]上海交通大学医学院附属同仁医院骨科,上海200336

出　　处：《创伤外科杂志》2016年第6期366-368,共3页Journal of Traumatic Surgery

摘　　要：目的探讨经伤椎短节段固定治疗A型胸腰椎骨折疗效。方法回顾性分析2009年6月~2014年6月收治的A型（新AO分型）胸腰椎骨折患者共58例,所有患者手术方法均为麻醉下牵引推压复位后经伤椎短节段椎弓根螺钉固定。统计手术时间、术中出血量及术后引流量,评估患者术前与术后1周、术后3个月、1年随访时胸腰椎疼痛的视觉模拟评分（VAS）、椎体高度变化、椎间角矫正情况,利用SPSS14.0进行统计分析。结果 58例患者均获得〉1年的随访,平均18.2个月,手术时间平均92.3min,术中出血量平均251m L,术后引流量平均189m L,与术前比较,术后伤椎前缘高度明显增加,椎间角明显减小,VAS评分明显改善（P均〈0.05）;术后1周、术后3个月、术后1年椎体前缘高度比较无统计学差异（P〉0.05）。结论经伤椎短节段置钉治疗A型胸腰椎骨折能有效重建椎体高度,且远期疗效确切,值得临床推广应用。Objective To evaluate the clinical efficacy of short-segment pedicle screws fixation via the injured thoracolumbar vertebrae in treating type A thoracolumbar fracture. Methods Totally 58 cases of type A thoracolumabr vertebral fractures treated by short-segment fixation were retrospectively analyzed from Jun. 2009 to Jun.2014. Pressing and traction were used to reduce the kyphosis of the injured vertebrae before the pedicle screws were inserted. The operation time,blood loss volume and postoperative bleeding were recorded. VAS score,compression vertebral height and kyphosis angle of the fractured vertebrae were recorded and compared at time points of before operation,1 week,3 months and 1 year after fixation. SPSS 14. 0 was used for statistical analysis. Results All the58 patients achieved more than 1-year follow-up. The operation time,volume of blood loss and postoperative bleeding were 92. 3min,251 m L,189 m L,respectively. VAS score,compression vertebral height and the kyphosis angle of the fractured vertebrae were significantly improved after operation（ P 0. 05）. There was no remarkable difference in compression vertebral height among time points of 1 week,3 months and 1-year follow-up（ P 0. 05）. Conclusion For treating type A thoracolumbar fractures,short-segment fixation via the injured vertebrae can effectively improve the vertebral height,and have a satisfactory long-term effect,which is worthy of clinical application.

关 键 词：胸腰椎骨折 伤椎 短节段固定 

分 类 号：R687.3[医药卫生—骨科学]