Kumafix内固定系统治疗胸腰段椎体骨折的疗效观察：基于5年以上的随访  

Kumafix fixation system for treatment of thoracolumbar vertebral fractures： based on more than 5 years＇ follow-up

作　　者：许正伟[1] 刘团江[1] 何立民[1] 郑永宏[1] 王栋琪[1] 郝定均[1] 

机构地区：[1]西安交通大学医学部附属红会医院脊柱外科颈椎病区,710054

出　　处：《美中国际创伤杂志》2017年第1期1-4,21,共5页U.S.Chinese International Journal of Traumatology

摘　　要：目的：探讨Kumafix脊柱后路钉棒系统（Kumafix系统）在胸腰段椎体骨折治疗中的疗效。方法：选择2011年1月至2011年7月收治的131例胸腰段椎体骨折患者，所有患者均满足TLICS≥5分，同时脊柱载荷评分（LSC）评分1〉4分，且≤6分。按抛硬币法随机分为A、B两组。A组（72例）采用Kumafix系统进行复位固定，并伤椎经椎弓根植骨，其中男41例，女31例；年龄（41．2±4．9）岁（20～53岁）。B组（59例）采用普通后路U型钉棒系统进行复位固定，并伤椎经椎弓根植骨，其中男33例，女26例，年龄（40．6±4．5）岁（21。51岁）。比较两组患者手术时间、出血量、椎体前缘高度比值、椎体中央高度比值、椎体后缘高度比值、后凸Cobb角、Oswestry功能障碍指数（Oswestry disability index，ODD，和相邻节段退变发生率等。结果：所有患者均获得随访平均5-3年（5．1—5．8年）。两组比较，A组手术时间、出血量少于B组（P〈0．05）。两组术后椎体前缘高度比值、椎体中央高度比值、椎体后缘高度比值、后凸Cobb角、较术前明显改善（P〈0．05）。末次随访时，A组椎体中央高度比值要优于B组（P〈0．05）。两组术后ODI均优于术前，A组末次随访时ODI优于B组（P〈0．05）。末次随访时，A组相邻节段退变的发生率要低于B组（P〈0．05）。结论：对于胸腰段椎体骨折，与普通后路U型钉棒系统比较，Kumafix系统具有更精准和更佳的复位效果，操作简单，安全可靠，有效避免了内固定对相邻关节突的影响。Objective： To investigate the curative effect of Kumafix posterior spinal screw/rod system （Kmnafix system） for thoraeolumbar vertebral fractures. Methods： 131 patients with thoracolumbar vertebral fractures between January and July 2011 were selected and divided into group A and group B according to coin toss method. All patients must have the following conditions： TLICS were ≥5 points, spinal load-sharing classification （LSC） were ≥4 and ≤6 points. Group A patients （72 cases, 41 male and 31 female, 20-53 years old） underwent posterior reduction and fixation with Kumafix system and group B patients （59 cases, 33 male and 26 female, 21-51 years old） with U-shaped screw/rod system, and following by transpedicular bone grafting of the fractured vertebrae in all patients. The operation time, blood loss, post-operative anterior, middle and posterior vertebral height ratio, Cobb＇s angle, ODI, the incidence of adjacent segment degeneration and so on were compared and analyzed. Results： All patients were followed up for average 5.3 years （range, 5.1-5.8 years）, with an obvious improvement in Cobb＇s angle and anteriorl middle, posterior vertebral height ratio （P〈0.05）. Operation time and blood loss of group A were shorter and less than that of group B （P〈0.05）. At the last follow-up, the incidence of adjacent segment degeneration and middle vertebral height ratio of group A were lower and superior than that of group B （P〈0.05）, ODI score was improved in two groups especially in group A which was better than group B （P〈0.05）. Conclusion： For treatment of thoracolumbar vertebral fractures,the Kumafix system has more precise and better reduction effect in comparison with U-shaped screw/rod system. Meanwhile, Kumafix system is not only safe and simple performance, but also can avoid an influence of internal fixation on adjacent articular process effectively.

关 键 词：脊柱骨折 胸椎 腰椎 Kumafix系统 疗效 

分 类 号：R683.2[医药卫生—骨科学]