Denis B型胸腰椎爆裂性骨折行后路单节段钛网重建术对邻近节段的影响  

The effect on adjacent segment by posterior single-segment titanium mesh fusion in the treatment of Denis type B thoracolumbar burst fractures

作　　者：马雪峰[1] 贺旭[1] 刘恺[1] 马鹏飞 阮烨[1] 易小波[1] MA Xue-feng;HE Xu;LIU Kai;MA Peng-fei;RUAN Ye;YI Xiao-bo(Dept of Spinal Surgery,Shenzhen Pingle Orthopaedics Hospital,Shenzhen,Guangdong 518100,China)

机构地区：[1]深圳平乐骨伤科医院脊柱外科,广东深圳518100

出　　处：《临床骨科杂志》2019年第1期19-21,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨Denis B型胸腰椎爆裂性骨折行后路单节段钛网重建术对邻近节段的影响。方法 20例Denis B型胸腰椎爆裂性骨折患者行后路单侧椎体次全切除、脊髓270°减压、钛网植骨重建前中柱及椎弓根钉内固定并后路重建术。1年后取出钉棒内固定并继续随访1～3年。末次随访通过动力位X线片、MRI评估邻近节段椎间盘变化情况。结果末次随访时,患者钛网均无松动。有2例患者出现不同程度塌陷,Cobb角有所丢失。所有患者远端椎间盘有不同程度退变,椎间隙未见明显变窄,邻近节段椎间盘退变Pfirrmann分级:Ⅰ级退变13例,Ⅱ级退变5例,Ⅲ级退变1例,Ⅳ级退变1例。结论后路单节段固定钛网重建治疗Denis B型胸腰椎爆裂性骨折加速邻近节段椎间盘退行性变。ObjectiveTo evaluate the effect on adjacent segment by posterior single-segment decompression and reconstruction for treatment of Denis type B thoracolumbar burst fractures.Methods The 20 patients with Denis type B thoracolumbar burst fractures were treated with unilateral subtotal vertebraectomy with the posterior approach,270°decompression,titanium mesh supporting bone autograft for reconstruction of the anterior and middle columns,pedicle screw fixation,and the posterior construction.The screw-rod was removed at 1 year after surgery and continued to gain 1~3 years follow-up.The change of adjacent segment intervertebral disc was evaluated by power position X-ray film and MRI at the last follow-up.ResultsAt last follow-up,no titanium mesh loosening occurred.There were different degrees collapse in 2 cases,Cobb angel had a litte loss,all cases of the distal intervertebral disc had different degree degeneration,there wasn′t significant narrowing of the intervertebral space.Pfirrmann grading of adjacent segment intervertebral disc degeneration:degreeⅠdegeneration was in 13 cases,degree Ⅱ 5 cases,degree Ⅲ 1, degree Ⅳ 1.ConclusionsThe operation of posterior single-segment fusion for the treatment of Denis type B thoracolumbar burst fractures accelerates adjacent segment degeneration.

关 键 词：胸腰椎骨折 邻近节段退变 单节段钛网重建 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]