胸腰椎骨折术后矫正度丢失与伤椎形态量表的相关性研究  

Relationship between the postoperative loss of kyphosis correction degree of thoracolumbar fracture and injured vertebra morphology scale

作　　者：薛燚[1] 邵益民[1] 张永良[1] 王强[1] 

机构地区：[1]南京中医药大学附属常熟医院,江苏215500

出　　处：《创伤外科杂志》2016年第12期725-728,共4页Journal of Traumatic Surgery

摘　　要：目的探讨胸腰椎骨折术后伤椎矫正度丢失与伤椎形态量表的相关性。方法选取2011年6月~2013年6月后路短节段固定治疗的胸腰椎骨折患者52例,测量患者术前、术后3d及取出内固定3d后的矢状位Cobb角、伤椎压缩率及伤椎上下椎间隙高度,计算矫正度丢失率,并在术前按自制伤椎形态量表对所有伤椎进行评分并分组,对量表评分和矫正度丢失率进行相关性分析。结果所有患者随访13~19个月,平均15.5个月,自制形态量表评分和矫正度丢失率存在明显相关性。三组患者矫正度丢失具有明显差异（P〈0.05）,轻度组Cobb角丢失0.5°,压缩率丢失0.6%;中度组Cobb角丢失2.7°,压缩率丢失4.4%;重度组Cobb角丢失4.1°,压缩率丢失8.4%,说明伤椎量表评分等级高的患者在术后伤椎矫正度丢失越明显,重度组有断钉等并发症。结论自制伤椎形态量表与术后矫正度丢失存在相关性,该量表对胸腰椎骨折的处理有一定的指导意义。Objective To evaluate the relationship between the loss of kyphosis correction degree of thora-columbar fracture and injured vertebra morphology scale .Methods From Jun.2011 to Jun.2013,56 patients with thoracolumbar fracture received treatment of posterior cross segment pedicle fixation .Before and after surgery and at follow-up,Cobb angle ,vertebral compression rate and disc space height next to the injured vertebra were evaluated . All the patients were divided into 3 groups according to the scale .The loss of kyphosis correction degree and disc space height were compared among the 3 groups, and the relationship between the loss of kyphosis correction degree and injured vertebra morphology scale was analyzed . Results All the patients were followed up for 13 to 19 months,with an average of 15.5 months.The loss of kyphosis correction degree and injured vertebra morphology scale were obviously related .The correction degree loss was significantly different within the 3 groups （ P〈0.05 ）;the loss of Cobb angle was 0.5°and the loss of vertebral compression rate was 0.6% in the mild group;the loss of Cobb angle was 2.7°and the loss of vertebral compression rate was 4.4% in the moderate group;the loss of Cobb angle was 4.1°and the loss of vertebral compression rate was 8.4% in the severe group with internal fixation bro-ken.The results indicated that patients with higher scale were more likely to develop complications with obvious loss of vetebral compression rate .Conclusion The loss of kyphosis correction degree and injured vertebra morphology scale are obviously associated ,and the scale has a great guiding significance in the treatment of thoracolumbar frac-tures.

关 键 词：胸腰椎骨折 椎体 矫正度 形态量表 

分 类 号：R681.5[医药卫生—骨科学]