胸腰椎爆裂骨折患者伤椎置钉与不置钉的术后骨折愈合、创伤程度、神经功能恢复的评估  

Assessment of postoperative fracture healing,trauma degree and neurological functional recovery in thoracolumbar burst fracture patients with or without screw placement in injured vertebra

作　　者：杜增峰[1] 朱强[1] 马晓磊[1] 贺耀耀 马志远[1] 薛春堂[1] 

机构地区：[1]陕西省榆林市第一医院骨一科,陕西榆林718000

出　　处：《海南医学院学报》2016年第20期2420-2423,共4页Journal of Hainan Medical University

基　　金：陕西省科学技术项目(SX-4213-BBX)~~

摘　　要：目的:研究胸腰椎爆裂骨折患者伤椎置钉与不置钉的术后骨折愈合、创伤程度、神经功能恢复情况。方法:选择在我院接受后路短节段椎弓根螺钉固定的单节段胸腰椎爆裂性骨折患者作为研究对象,根据伤椎置钉与否分为置钉组(A组)和不置钉组(B组),随访骨折愈合情况并测量伤椎前缘高度、Cobb’s角,术后3d时测定血清中pNF-H、HSP70、NSE、S100β、GFAP、IL-1β、IL-6、IL-8、IL-10、TNF-α、MPO的含量。结果:两组术后1周、半年、1年时的伤椎前缘高度显著高于手术前、Cobb’s角显著低于手术前,差异具有统计学意义(P<0.05);两组术后半年、1年时的伤椎前缘高度显著低于手术后1周、Cobb’s角显著高于手术前1周,差异具有统计学意义(P<0.05);A组手术后半年、手术后1年时的伤椎前缘高度显著高于B组、Cobb’s角显著低于B组,差异具有统计学意义(P<0.05);手术后3d时,两组血清中pNF-H、HSP70、NSE、S100β、GFAP、IL-1β、IL-6、IL-8、IL-10、TNF-α、MPO的含量无显著性差异。结论:后路短节段椎弓根螺钉固定治疗胸腰椎爆裂性骨折时进行伤椎置钉能够减少椎体高度以及后凸畸形矫正的丢失、改善远期脊髓神经功能且不增加手术创伤。Objective：To study the postoperative fracture healing,trauma degree and neurological functional recovery in thoracolumbar burst fracture patients with or without screw placement in injured vertebra.Methods：Patients with single-segment thoracolumbar burst fracture who received posterior short-segment pedicle screw fixation in our hospital were selected and divided into screw placement group（group A）and no screw placement group（group B）according to the presence of screw placement in injured vertebra or not.Followed up on fracture healing was conducted,the injured vertebral anterior height and Cobb＇s angle were measured,and serum pNF-H,HSP70,NSE,S100β,GFAP,IL-1β,IL-6,IL-8,IL-10,TNF-αand MPO content were determined 3dafter operation.Results：Injured vertebral anterior height of both groups 1week,half a year and 1year after operation were significantly higher than those before operation but Cobb＇s angle were significantly lower than those before operation（P〈0.05）,injured vertebral anterior height of two groups half a year and 1year after operation were significantly lower than those 1week after operation and Cobb＇s angle were significantly higher than those 1week after operation（P〈0.05）,injured vertebral anterior height of group A half a year and 1year after operation were significantly higher than those of group B and Cobb＇s angle were significantly lower than those of group B（P〈0.05）;3dafter operation,serum pNF-H,HSP70,NSE,S100β,GFAP,IL-1β,IL-6,IL-8,IL-10,TNF-αand MPO content were not significantly different between two groups of patients.Conclusion：Screw placement in injured vertebra in posterior short-segment pedicle screw fixation treatment of thoracolumbar burst fracture can reduce the loss of vertebral height and kyphosis correction and improve long-term spinal nerve function without increasing the surgical trauma.

关 键 词：胸腰椎爆裂性骨折 短节段椎弓根螺钉固定 伤椎置钉 脊髓损伤 神经功能 

分 类 号：R683.2[医药卫生—骨科学]