胸腰椎后外侧钉棒系统前后一体固定技术治疗胸腰椎疾病效果观察  

Effect of anterior-posterior fixation by posterolateral screw-rod system on thoracolumbar diseases

作　　者：朱永生 孙振中 汪建良 徐耀增[3] ZHU Yongsheng;SUN Zhenzhong;WANG Jianliang;XU Yaozeng(Department of Orthopedics,the Ninth People＇s Hospital of Wuxi,Wuxi 214062,China)

机构地区：[1]无锡市第九人民医院骨科,江苏无锡214044 [2]无锡市太湖医院骨科,江苏无锡214044 [3]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中华实用诊断与治疗杂志》2018年第10期965-967,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81272018)

摘　　要：目的评价胸腰椎后外侧钉棒系统前后一体固定技术治疗胸腰椎疾病的临床效果。方法回顾性分析经胸腰椎后外侧钉棒系统前后一体固定技术治疗的60例胸腰椎疾病患者临床资料,其中胸、腰椎椎间盘突出症35例,脊柱外伤10例,脊柱肿瘤8例,脊柱结核7例;利用疼痛评分、影像学指标和神经功能评分等比较术前、术后和末次随访时患者治疗效果。结果 60例患者手术均顺利,全部患者均获随访,平均随访时间30个月;术后3d疼痛视觉模拟评分(visual analogue scale,VAS)[(3.50±1.00)分]较术前[(7.90±0.90)分]降低(P<0.05),伤椎Cobb角[(5.08±1.22)°]较术前[(29.12±3.01)°]减小(P<0.05),伤椎前缘、后缘压缩率[(9.67±2.89)%、(10.34±3.01)%]较术前[(55.75±4.99)%、(44.03±5.22)%]减少(P<0.05),椎管狭窄率[(10.14±2.69)%]较术前[(60.98±20.21)%]降低(P<0.05);术后3d与末次随访时VAS评分、Cobb角度数、以及椎管狭窄率比较差异均无统计学意义(P>0.05);2例术后脊髓神经功能无改善,其余患者均有1级或1级以上的恢复(P<0.05)。结论胸腰椎疾病经胸腰椎后外侧钉棒系统前后一体固定技术治疗后可减轻疼痛,影像学指标及神经功能改善。Objective To evaluate the clinical effect of anterior-posterior fixation by posterolateral screw-rod system on thoracolumbar diseases.Methods The clinical data of 60 patients with thoracolumbar disorders receiving anteriorposterior fixation by posterolateral screw-rod system were retrospectively analyzed.The clinical effects were compared by observing the changes of visual analogue scale,imaging parameters and neurological function scores before surgery,after surgery and at the final follow-up.Results Sixty patients with thoracolumbar disease included 35 patients with thoracolumbar disc herniation,10 with spinal trauma,8 with spinal tumors and 7 with spinal tuberculosis.All patients were followed up with a mean follow-up of 30 months.The visual analogue scale score was significantly lower（3.50±1.00）,the Cobb angle was significantly smaller（（5.08±1.22）°）,the compression rates at the leading and trailing edges were significantly lower（（9.67±2.89）%,（10.34±3.01）%）,and the compression spinal cord stenosis rate was significantly lower（（10.14±2.69）%）than those before operation by day 3 after operation than those before operation（（7.90±0.90,（29.12±3.01）°,（29.12±3.01）°,（55.75±4.99）%,（44.03±5.22）%,（60.98±20.21）%）（P〈0.05）.There were no significant differences in the visual analogue scale score,Cobb angle and spinal cord stenosis rate by day 3 after operation in comparison with those at the final follow-up（P〉0.05）.Except 2 patients with no improvement in neurological function,the other patients had grade 1 or greater recovery（P〈0.05）.Conclusion Anterior-posterior fixation by posterolateral screw-rod system could obviously reduce pain caused by thoracolumbar diseases,and the imaging parameters and neurological function are significantly improved.

关 键 词：胸腰椎疾病 钉棒系统 前后一体固定技术 神经功能 

分 类 号：R687.3[医药卫生—骨科学]